Carcinoma of the vulva. Significance of surgical margin involvement in assessing prognosis.
Repeat pathologic analysis was completed in order to independently assign surgical margin status in a group of 61 patients from the Ohio State University gynecologic oncology tumor registry. Patients were entered into the study group after having undergone simple or radical vulvectomy for squamous carcinoma of the vulva. A statement regarding margin status was made following a detailed pathologic review, and parameters--including stage, grade and lymph node involvement--were assigned without regard to outcome. There was no statistically significant difference in the survival or recurrence rate with involved margins. Mean lesion size was significantly larger with involved margins (P less than .05). The survival and recurrence data support a primary surgical attempt at complete excision regardless of the microscopic margin status.
TO THE EDITOR: ::: ::: A focus on defining genomic mutations at the whole population level in cancer may underestimate clonal plasticity in the tumor genome and how it generates genetic variation between individual single cells (SCs). This may have an impact on understanding cancer evolution and biological