Concordance of gross surgical and final fixed margins in vulvar intraepithelial neoplasia 3 and vulvar cancer

Christopher P. DeSimone, Meredith P. Crisp, Frederick R. Ueland, Paul D. DePriest, John R. Van Nagell, Subodh M. Lele, Susan C. Modesitt

Research output: Contribution to journalArticle

2 Scopus citations

Abstract

OBJECTIVE: To prospectively evaluate the concordance of initial surgical vulvar margins and final fixed margins and to determine the amount of microscopic pathology of grossly negative margins in women with vulvar intraepithelial neoplasia (VIN) 3 or vulvar carcinoma. STUDY DESIGN: Women with VIN 3 or vulvar carcinoma undergoing surgical excision were identified. Prior to excision, acetic acid was used to highlight the lesions, and 2 sutures were placed, 1 at the edge of gross disease and another 1 cm distal from the first. After specimen removal and fixation, the distance between sutures and microscopic involvement of VIN was determined. RESULTS: Twenty-seven women were enrolled; however, only 19 had final fixed specimens that could be accurately measured. The median fixed distance of the vulvar margin was 0.85 cm (mean, 0.83; SD, 0.19) as compared to the gross, 1-cm margin (p = 0.001). Three subjects (16%) had microscopic involvement by VIN 3 in the grossly negative epithelium between the 2 sutures, but none had a positive peripheral margin. CONCLUSION: The gross surgical margin after vulvar resection is reduced by 15% when measured in its final fixed state, and a grossly negative 1-cm margin will seldom harbor significant disease.

Original languageEnglish (US)
Pages (from-to)617-620
Number of pages4
JournalJournal of Reproductive Medicine for the Obstetrician and Gynecologist
Volume51
Issue number8
Publication statusPublished - Aug 1 2006

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Keywords

  • Surgical margins
  • Vulvar cancer
  • Vulvar diseases

ASJC Scopus subject areas

  • Reproductive Medicine
  • Obstetrics and Gynecology

Cite this

DeSimone, C. P., Crisp, M. P., Ueland, F. R., DePriest, P. D., Van Nagell, J. R., Lele, S. M., & Modesitt, S. C. (2006). Concordance of gross surgical and final fixed margins in vulvar intraepithelial neoplasia 3 and vulvar cancer. Journal of Reproductive Medicine for the Obstetrician and Gynecologist, 51(8), 617-620.