title: European Nationality Influence in the Management of Squamous Cell Vulvar Cancer.
abstract: OBJECTIVE
  Vulvar cancer is a rare disease. In western European countries, the incidence is 1.2 cases per 100,000 women/year. The aim of this study was to analyze the management and disease-free survival (DFS) of vulvar cancer among European countries.
  
  
  METHODS
  An international multicenter retrospective study including patients diagnosed of squamous cell vulvar cancer was performed. Countries analyzed included Austria, Germany, Greece, Italy, Latvia, Lithuania, Poland, Portugal, Spain and Turkey. One hundred different centers were enrolled including 1,505 squamous cell tumors treated from January 2001 until December 2005.
  
  
  RESULTS
  The mean free surgical margin was 9.93 mm, which was different between countries (p = 0.076); it ranged from 5.79 mm (95% CI 4.44-7.13) in Germany to 33.39 mm (95% CI 22.21-44.58) in Lithuania. The global 5-year overall survival rate was 61.4%, and the global 5-year DFS rate was 32%. DFS times were different between countries as well as the treatments carried out. The country with the shortest DFS time had 15.9 ± 3.1 months compared to the one with the longest time with 66.0 ± 17.4 months.
  
  
  CONCLUSIONS
  Wide differences in treatments and DFS times have been observed between countries. Homogeneous management for squamous cell vulvar cancer is needed to obtain the best survival rates for all patients.
authors.affiliation: Gynecologic Oncology Unit, La Paz University Hospital - IdiPAZ, Madrid, Spain.
authors.forename: Sara
authors.initials: S
authors.lastname: Iacoponi
authors.forename: Ignacio
authors.initials: I
authors.lastname: Zapardiel
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000208:ethnology* / Q000401:mortality / Q000601:surgery; D019468:Disease Management; D018572:Disease-Free Survival; D005060:Europe / Q000208:ethnology; D005260:Female; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D012189:Retrospective Studies; D015996:Survival Rate; D014846:Vulvar Neoplasms / Q000208:ethnology* / Q000401:mortality / Q000601:surgery; D044465:White People / Q000208:ethnology / Q000706:statistics & numerical data*
keywords: European countries; Management; VULCAN study; Vulvar cancer