The following is a summary of “Defining and quantifying histopathologic risk factors for regional and distant metastases in a large cohort of vulvar squamous cell carcinomas,” published in the NOVEMBER 2023 issue of Dermatology by Cheraghlou, et al.

Vulvar squamous cell carcinoma (vSCC) is a rare tumor with a favorable prognosis in localized stages. However, once regional or distant metastasis occurs, vSCC can progress rapidly and become life-threatening. Identifying prognostic features was crucial for prioritizing high-risk cases for further diagnostic workup and treatment. For a study, researchers sought to estimate the risk of regional or distant metastasis at presentation and sentinel lymph node status for vSCC based on histopathologic characteristics.

A retrospective cohort study analyzed 15,188 adult vSCC cases from the National Cancer Database diagnosed between 2012 and 2019.

The study provides specific estimates of the risk of clinically positive nodes and metastatic disease at presentation, as well as sentinel lymph node positivity based on tumor size, moderate/poor tumor differentiation, and lymph-vascular invasion. Multivariable analysis confirmed the significant association of these histopathologic factors with the tested clinical outcomes. Moderate (hazard ratio, 1.190; P < .001), poor differentiation (hazard ratio, 1.204; P < .001), and lymph-vascular invasion (hazard ratio, 1.465; P < .001) were also linked to significantly poorer overall survival.

The study established the association of vSCC histopathologic characteristics with clinically relevant outcomes. The information can guide discussions on diagnostic and treatment recommendations, especially regarding sentinel lymph node biopsy, and inform future staging and risk stratification efforts for vSCC.

Source: jaad.org/article/S0190-9622(23)00539-X/fulltext