Table 3.
Multivariable Cox and Fine–Gray regression analyses comparing all vulvar recurrences, and primary and remote vulvar recurrences to clinico-pathological variables.
| Variable Title | All Vulvar Recurrence | Primary Vulvar Recurrence | Remote Vulvar Recurrence |
|---|---|---|---|
| HR (95% CI) p-value | SHR (95% CI) p-value | SHR (95% CI) p-value | |
| Age >65 years (Ref: ≤65 years) | 0.58 (0.33−1.00) 0.05 | 0.49 (0.18−1.33) 0.16 | 0.62 (0.31−1.23) 0.17 |
| Current smoker—Yes (Ref: No) | 0.42 (0.20−0.87) 0.02 | 0.51 (0.16−1.62) 0.26 | 0.41 (0.16−1.05) 0.06 |
| Tumour >4 cm (Ref: ≤4 cm) | 1.34 (0.64−2.82) 0.44 | 2.41 (0.57−10.13) 0.23 | 0.84 (0.24−2.94) 0.79 |
| Margin distance (Ref: ≥8 mm) | |||
| <5 mm margins | 2.29 (1.12−4.70) 0.02 | 15.19 (5.21−44.26) < 0.001 | 0.00 † |
| 5 mm to <8 mm margins | 1.31 (0.69−2.49) 0.41 | 8.92 (3.26−24.43) < 0.001 | 0.08 (0.01−0.71) 0.02 |
| Margin treatment | |||
| <8 mm treated margins (Ref: all other margins) | 0.15 (0.05−0.44) < 0.001 | 0.14 (0.05−0.41) < 0.001 | 0.00 † |
| Nodal status a—Positive (Ref: negative) | 1.77 (1.05−3.01) 0.03 | 3.05 (1.18−7.89) 0.02 | 1.07 (0.49−2.32) 0.86 |
| Tumour differentiation | |||
| Mod/Poor (Ref: well differentiated) | 1.17 (0.70−1.96) 0.54 | 1.28 (0.50−3.27) 0.61 | 1.25 (0.65−2.40) 0.50 |
| LVSI present (Ref: not present) | 1.62 (0.77−3.42) 0.21 | 1.07 (0.33−3.47) 0.91 | 2.74 (0.73−10.29) 0.14 |
| PNI present (Ref: not present) | 1.72 (0.61−4.88) 0.31 | 2.06 (0.51−8.30) 0.31 | 0.50 (0.03−7.11) 0.61 |
| Depth of invasion—>5 mm (Ref: ≤5 mm) | 0.77 (0.44−1.36) 0.37 | 0.66 (0.26−1.68) 0.38 | 0.96 (0.47−1.95) 0.91 |
| Epithelial abnormality (Ref: No abnormality) b | |||
| Lichen sclerosus (LS) +/- SH | 1.72 (0.81−3.65) 0.16 | 2.34 (0.55−9.92) 0.25 | 1.46 (0.60−3.53) 0.40 |
| dVIN present, not at margin | 0.96 (0.41−2.27) 0.93 | 1.59 (0.40−6.31) 0.51 | 0.70 (0.19−2.60) 0.59 |
| dVIN at margin | 2.37 (0.94−5.99) 0.07 | 5.35 (1.05−27.34) 0.04 | 1.65 (0.56−4.87) 0.36 |
| uVIN present | 0.42 (0.17−1.02) 0.06 | 0.47 (0.09−2.45) 0.37 | 0.46 (0.17−1.27) 0.13 |
| LS + dVIN | 0.59 (0.18−1.97) 0.39 | 0.52 (0.05−5.58) 0.59 | 0.96 (0.24−3.90) 0.96 |
HR indicates hazard ratio; SHR, subdistribution hazard ratio; CI, confidence interval; Ref, Reference group; LVSI, lymphovascular space invasion; PNI, perineural invasion; SH, squamous hyperplasia; dVIN, differentiated vulvar intraepithelial neoplasia; uVIN, usual-type vulvar intraepithelial neoplasia. a One patient nodal status unknown, b One patient with both dVIN and uVIN excluded from analysis. † The SHR could not be estimated as no remote recurrences were observed in the <5 mm and treated margin groups.