Table 2.

Summary of the case characteristics of the 8 VLMS of the DKSM.

Pt Nr	Age (years)	Menopausal state	Presenting symptom	Initial diagnosis	Tumor size	Initial surgery	2° surgery	R-Status
1	45	Premenopausal	Painful growing swelling	Bartholin‘s gland cyst or abscess	76 mm	TE; not completely removed (R1)	Partial vulvectomy with partial negative margins after resection of the M. sphincter ani	R0 (positive margins after tumor excision, 2° operation)
2	52	Premenopausal	Occlusion of the introitus	chronic Bartholin‘s gland cyst	47 mm	TE	Re-excision recommended	R1
3	81	Postmenopausal	n.s.	n.s.	64 mm	radical vulvectomy with intraoperative frozen section to ensure complete resection	None	R0
4	53	Premenopausal	n.s.	vulvar tumor	25 mm	TE	Left hemi-vulvectomy	R0
5	73	Postmenopausal	n.s.	n.s.	35 mm	TE; not completely removed (R1)	Re-excision	R0
6	52	Peri-menopausal	Foreign body sensation, growing tumor	Bartholin‘s gland abscess	50 mm	marsupialization; tumor not completely removed (R1)	Right hemi-vulvectomy and negative margins after reconstruction by VY-flap plastic	R0 (positive margins after tumor excision, 2° operation)
7	68	Postmenopausal	Growing mass	tumor increasing in size	25 mm	TE; not completely removed (R1)	Radical right vulvectomy	R0
8	54	Peri-menopausal	n.s.	Bartholin‘s gland abscess	33 mm	TE; completely removed	None	R0

Pt Nr	Margins	Tumor stage	Grading	Caldesmon	Desmin	SMA	S-100	Ki-67
1	Resection margin ≥5 mm	pT2 pNx L0 V0 Pn0 cM0	G2	+	+	+	n.s.	5%
2	Margins partially infiltrated	pT1a pNx Lx Vx Pnx cM0	G2	n.s.	n.s.	+	n.s.	30–70%
3	n.s.	pT2a pNx L0 V0 Pnx cM0	G1	+	n.s.	+	Negative	Slightly increased
4	Resection margin >10 mm	pT1a pNx Lx Vx Pnx cM0	G2	n.s.	+	+	n.s.	60%
5	Resection margin 3 mm	pT1a pNx Lx Vx Pnx cM0	G1	n.s.	+	+	n.s.	n.s.
6	n.s.	pT2a pNx Lx Vx Pnx cM0	G2	Focally +	+	+	Negative	30%
7	Resection margin ≥10 mm	pT1a pNx Lx Vx Pnx cM0	G3	Negative	Negative	+	Nuclear + in 10%	80%
8	n.s.	pT1a pNx L0 V0 Pnx cM0	G2	n.s.	+	(+)	Negative	50%

Pt Nr	Mitosis rate	ER	PR	Recommendation for adjuvant therapy	RT	CHT	Endocrine therapy	Follow-up
1	16 MF/10 HPF	n.s.	n.s.	RT	EBRT with boost; 25×2 Gy with a boost to the former tumor bed of 5×2 Gy (total of 60 Gy)	None	none	16 months
2	Frequent MF	n.s.	n.s.	Could not be made due to missing information on re-excision	none	None	none	106 months
3	5 MF/10 HPF	+	+	RT	n.s.	n.s.	n.s.	24 months
4	>10 MF/10 HPF	(+)	(+)	None	None	None	None	76 months
5	n.s.	n.s.	n.s.	RT	n.s.	n.s.	n.s.	48 months
6	n.s.	n.s.	n.s.	RT	EBRT, total dose of 60 Gy (single dose 2 Gy) to tumor region and regional lymph nodes	None	None	80 months
7	33 MF/10 HPF	(+), 5%	Negative	RT	applied (no further information)	None	None	70 months
8	13 MF/10 HPF	n.s.	n.s.	None	None	None	None	95 months

n.s. – not specified; TE – tumor excision; R1 – tumor cells found in the resection margin/tumor not completely removed; R0 – negative resection margins/tumor completely removed; pT – pathological tumor size; pNx – unknown pathological lymph node status; L0 – no lymphatic vessel invasion; Lx – unknown lymphatic vessel invasion; V0 – no blood vessel invasion; Vx – unknown blood vessel invasion; Pn0 – no perineural invasion; Pnx – unknown perineural invasion; cM0 – clinically no distant metastasis; MF – mitotic figure; HPF – high-power field; G1/G2/G3 – low/intermediate/high-grade; “+” – positive; (+) – weak positive; SMA – smooth muscle actin; ER – estrogen receptor; PR – progesterone receptor; S-100 – “soluble”-100; Ki-67 – (Kiel)-67 proliferation marker; RT – radiation therapy; EBRT – external beam radiation therapy; Gy – Gray; CHT – chemotherapy.