title: Vulval squamous cell carcinoma occurring on a background of differentiated vulval intraepithelial neoplasia is more likely to recur: a review of 154 cases.
abstract: OBJECTIVE
  To assess the frequency of recurrence of vulval carcinoma, arising from the background of usual-type vulval intraepithelial neoplasia (uVIN), differentiated VIN (dVIN, and nonneoplastic epithelial disorders (NNEDs).
  
  
  METHODS
  A retrospective review was conducted of 200 pathology specimens of vulval squamous cell carcinoma (VSCC) from 154 women over a 5-year period. The pathologic findings were reviewed where information of the adjacent pathology and number of recurrences of carcinoma for each woman were recorded. The number of recurrences was then correlated with the adjacent pathology using logistical regression analysis.
  
  
  RESULTS
  The overall recurrence rate for vulval carcinoma was 22.6%. A single recurrence occurred in 12.9% of patients, whereas 5.8% had 2 recurrences and 3.9% has 3 recurrences of vulval carcinoma. The odds ratio (OR) of having a recurrence of VSCC associated with dVIN alone is 3.85 (95% CI 0.52, 28.24) and 4.3 when associated with dVIN in combination with NNEDs (95% CI 0.84, 21.92), whereas with VSCC associated with uVIN the OR is 1.35 (95% CI 0.20, 9.01).
  
  
  CONCLUSIONS
  Vulval cancers arising on a background of dVIN appear more likely to recur than cancers arising from undifferentiated VIN; this is compounded by the concurrent presence of NNEDs.
authors.affiliation: Department of Gynecological Oncology, Pan Birmingham Cancer Center, Birmingham, England. loiseva@supanet.com
authors.forename: Lois J
authors.initials: LJ
authors.lastname: Eva
authors.forename: Raji
authors.initials: R
authors.lastname: Ganesan
authors.forename: Kiong K
authors.initials: KK
authors.lastname: Chan
authors.forename: Honest
authors.initials: H
authors.lastname: Honest
authors.forename: Sadia
authors.initials: S
authors.lastname: Malik
authors.forename: David M
authors.initials: DM
authors.lastname: Luesley
mesh_terms: D002294:Carcinoma, Squamous Cell / Q000473:pathology* / Q000628:therapy; D015331:Cohort Studies; D005260:Female; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology* / Q000473:pathology; D011230:Precancerous Conditions / Q000473:pathology*; D012189:Retrospective Studies; D012307:Risk Factors; D014846:Vulvar Neoplasms / Q000473:pathology* / Q000628:therapy