{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,30]],"date-time":"2026-05-30T13:00:36Z","timestamp":1780146036219,"version":"3.54.0"},"reference-count":40,"publisher":"Elsevier BV","issue":"2","license":[{"start":{"date-parts":[[2023,2,1]],"date-time":"2023-02-01T00:00:00Z","timestamp":1675209600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2023,2,1]],"date-time":"2023-02-01T00:00:00Z","timestamp":1675209600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2024,5,15]],"date-time":"2024-05-15T00:00:00Z","timestamp":1715731200000},"content-version":"vor","delay-in-days":469,"URL":"http:\/\/www.elsevier.com\/open-access\/userlicense\/1.0\/"}],"content-domain":{"domain":["mp.uscap.org","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Modern Pathology"],"published-print":{"date-parts":[[2023,2]]},"DOI":"10.1016\/j.modpat.2022.100010","type":"journal-article","created":{"date-parts":[[2023,1,9]],"date-time":"2023-01-09T16:07:22Z","timestamp":1673280442000},"page":"100010","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":13,"title":["p53-Abnormal \u201cFields of Dysplasia\u201d in Human Papillomavirus\u2013Independent Vulvar Squamous Cell Carcinoma Impacts Margins and Recurrence Risk"],"prefix":"10.1016","volume":"36","author":[{"given":"Emily F.","family":"Thompson","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard W.C.","family":"Wong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giorgia","family":"Trevisan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Basile","family":"Tessier-Cloutier","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noorah","family":"Almadani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela","family":"Cheng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony","family":"Karnezis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melissa K.","family":"McConechy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy","family":"Lum","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janine","family":"Senz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica N.","family":"McAlpine","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David G.","family":"Huntsman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Blake","family":"Gilks","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy","family":"Jamieson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3692-8057","authenticated-orcid":false,"given":"Lynn N.","family":"Hoang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.modpat.2022.100010_bib1","series-title":"Epidemiology, and End Results Program. SEER Cancer Stat Facts: Vulvar Cancer","year":"2020"},{"issue":"4","key":"10.1016\/j.modpat.2022.100010_bib2","doi-asserted-by":"crossref","first-page":"291","DOI":"10.1016\/j.pathol.2016.02.015","article-title":"Squamous precursor lesions of the vulva: current classification and diagnostic challenges","volume":"48","author":"Hoang","year":"2016","journal-title":"Pathology"},{"issue":"15 suppl","key":"10.1016\/j.modpat.2022.100010_bib3","doi-asserted-by":"crossref","first-page":"5592","DOI":"10.1200\/JCO.2019.37.15_suppl.5592","article-title":"p53 and p16 expression profiles reveal three prognostically relevant subgroups in vulvar cancer: a TMA based study by the AGO-CaRE-translational study group","volume":"37","author":"Woelber","year":"2019","journal-title":"J\u00a0Clin Oncol"},{"issue":"22","key":"10.1016\/j.modpat.2022.100010_bib4","doi-asserted-by":"crossref","first-page":"6781","DOI":"10.1158\/1078-0432.CCR-17-1302","article-title":"Genomic characterization of vulvar (pre)cancers identifies distinct molecular subtypes with prognostic significance","volume":"23","author":"Nooij","year":"2017","journal-title":"Clin Cancer Res"},{"issue":"3","key":"10.1016\/j.modpat.2022.100010_bib5","doi-asserted-by":"crossref","first-page":"649","DOI":"10.1016\/j.ygyno.2020.09.024","article-title":"Vulvar cancer subclassification by HPV and p53 status results in three clinically distinct subtypes","volume":"159","author":"Kortekaas","year":"2020","journal-title":"Gynecol Oncol"},{"issue":"3","key":"10.1016\/j.modpat.2022.100010_bib6","doi-asserted-by":"crossref","first-page":"622","DOI":"10.1016\/j.ygyno.2017.11.006","article-title":"Prognostic factors for local recurrence of squamous cell carcinoma of the vulva: a systematic review","volume":"148","author":"Te Grootenhuis","year":"2018","journal-title":"Gynecol Oncol"},{"issue":"1","key":"10.1016\/j.modpat.2022.100010_bib7","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1016\/j.ygyno.2015.09.077","article-title":"Sentinel nodes in vulvar cancer: long-term follow-up of the GROningen INternational Study on Sentinel nodes in Vulvar cancer (GROINSS-V) I","volume":"140","author":"Te Grootenhuis","year":"2016","journal-title":"Gynecol Oncol"},{"issue":"3","key":"10.1016\/j.modpat.2022.100010_bib8","doi-asserted-by":"crossref","first-page":"571","DOI":"10.1016\/j.ygyno.2019.07.009","article-title":"Predicting the course of disease in recurrent vulvar cancer\u2014a subset analysis of the AGO-CaRE-1 study","volume":"154","author":"Woelber","year":"2019","journal-title":"Gynecol Oncol"},{"issue":"8","key":"10.1016\/j.modpat.2022.100010_bib9","doi-asserted-by":"crossref","first-page":"1595","DOI":"10.1038\/s41379-020-0524-1","article-title":"Major p53 immunohistochemical patterns in in situ and invasive squamous cell carcinomas of the vulva and correlation with TP53 mutation status","volume":"33","author":"Tessier-Cloutier","year":"2020","journal-title":"Mod Pathol"},{"issue":"1","key":"10.1016\/j.modpat.2022.100010_bib10","doi-asserted-by":"crossref","first-page":"92","DOI":"10.1111\/his.14109","article-title":"Performance of the pattern-based interpretation of p53 immunohistochemistry as a surrogate for TP53 mutations in vulvar squamous cell carcinoma","volume":"77","author":"Kortekaas","year":"2020","journal-title":"Histopathology"},{"issue":"4","key":"10.1016\/j.modpat.2022.100010_bib11","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1097\/PGP.0000000000000263","article-title":"P16 immunostaining allows for accurate subclassification of vulvar squamous cell carcinoma into HPV-associated and HPV-independent cases","volume":"35","author":"Cheng","year":"2016","journal-title":"Int J Gynecol Pathol"},{"issue":"1","key":"10.1016\/j.modpat.2022.100010_bib12","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1097\/PGP.0b013e31826916c7","article-title":"The Lower Anogenital Squamous Terminology Standardization Project for HPV-associated lesions: background and consensus recommendations from the College of American Pathologists and the American Society for Colposcopy and Cervical Pathology","volume":"32","author":"Darragh","year":"2013","journal-title":"Int J Gynecol Pathol"},{"key":"10.1016\/j.modpat.2022.100010_bib13","author":"Singh"},{"issue":"4","key":"10.1016\/j.modpat.2022.100010_bib14","doi-asserted-by":"crossref","first-page":"e0196434","DOI":"10.1371\/journal.pone.0196434","article-title":"Formalin fixation increases deamination mutation signature but should not lead to false positive mutations in clinical practice","volume":"13","author":"Prentice","year":"2018","journal-title":"PLoS ONE"},{"issue":"1","key":"10.1016\/j.modpat.2022.100010_bib15","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1097\/PAS.0000000000000291","article-title":"Expanding the morphologic spectrum of differentiated VIN (dVIN) through detailed mapping of cases with p53 loss","volume":"39","author":"Singh","year":"2015","journal-title":"Am J Surg Pathol"},{"key":"10.1016\/j.modpat.2022.100010_bib16","series-title":"Female Genital Tumours","author":"Lokuhetty","year":"2020"},{"issue":"1","key":"10.1016\/j.modpat.2022.100010_bib17","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1111\/his.13989","article-title":"Vulval squamous cell carcinoma and its precursors","volume":"76","author":"Singh","year":"2020","journal-title":"Histopathology"},{"issue":"1","key":"10.1016\/j.modpat.2022.100010_bib18","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1097\/00004347-200101000-00003","article-title":"Vulvar intraepithelial neoplasia: historical aspects and current status","volume":"20","author":"Hart","year":"2001","journal-title":"Int J Gynecol Pathol"},{"issue":"2","key":"10.1016\/j.modpat.2022.100010_bib19","doi-asserted-by":"crossref","first-page":"305","DOI":"10.1007\/s00428-021-03070-0","article-title":"Histological interpretation of differentiated vulvar intraepithelial neoplasia (dVIN) remains challenging\u2014observations from a bi-national ring-study","volume":"479","author":"Dasgupta","year":"2021","journal-title":"Virchows Arch"},{"issue":"3","key":"10.1016\/j.modpat.2022.100010_bib20","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1097\/LGT.0000000000000211","article-title":"Differentiated vulvar intraepithelial neoplasia: what criteria do we use in practice?","volume":"20","author":"Reutter","year":"2016","journal-title":"J\u00a0Low Genit Tract Dis"},{"issue":"6","key":"10.1016\/j.modpat.2022.100010_bib21","doi-asserted-by":"crossref","first-page":"874","DOI":"10.1038\/modpathol.2012.235","article-title":"Interobserver variability and the effect of education in the histopathological diagnosis of differentiated vulvar intraepithelial neoplasia","volume":"26","author":"van den Einden","year":"2013","journal-title":"Mod Pathol"},{"issue":"6","key":"10.1016\/j.modpat.2022.100010_bib22","doi-asserted-by":"crossref","first-page":"957","DOI":"10.1111\/his.14442","article-title":"Interobserver reproducibility of the diagnosis of differentiated exophytic vulvar intraepithelial lesion (DEVIL) and the distinction from its mimics","volume":"79","author":"Neville","year":"2021","journal-title":"Histopathology"},{"issue":"6","key":"10.1016\/j.modpat.2022.100010_bib23","doi-asserted-by":"crossref","first-page":"574","DOI":"10.1097\/PGP.0000000000000280","article-title":"The natural history of vulvar intraepithelial neoplasia, differentiated type: evidence for progression and diagnostic challenges","volume":"35","author":"Bigby","year":"2016","journal-title":"Int J Gynecol Pathol"},{"issue":"3","key":"10.1016\/j.modpat.2022.100010_bib24","doi-asserted-by":"crossref","first-page":"268","DOI":"10.1111\/j.1365-2559.2005.02321.x","article-title":"p53 immunostaining in lichen sclerosus is related to ischaemic stress and is not a marker of differentiated vulvar intraepithelial neoplasia (d-VIN)","volume":"48","author":"Liegl","year":"2006","journal-title":"Histopathology"},{"issue":"6","key":"10.1016\/j.modpat.2022.100010_bib25","doi-asserted-by":"crossref","first-page":"828","DOI":"10.1097\/PAS.0000000000001047","article-title":"Differentiated vulvar intraepithelial neoplasia-like and lichen sclerosus-like lesions in HPV-associated squamous cell carcinomas of the vulva","volume":"42","author":"Rakislova","year":"2018","journal-title":"Am J Surg Pathol"},{"issue":"5","key":"10.1016\/j.modpat.2022.100010_bib26","doi-asserted-by":"crossref","first-page":"851","DOI":"10.1016\/j.ejca.2008.11.037","article-title":"Vulvar squamous cell carcinoma development after diagnosis of VIN increases with age","volume":"45","author":"van de Nieuwenhof","year":"2009","journal-title":"Eur J Cancer"},{"issue":"2","key":"10.1016\/j.modpat.2022.100010_bib27","doi-asserted-by":"crossref","first-page":"508","DOI":"10.1038\/s41379-020-00651-3","article-title":"Molecular characterization of invasive and in situ squamous neoplasia of the vulva and implications for morphologic diagnosis and outcome","volume":"34","author":"Tessier-Cloutier","year":"2021","journal-title":"Mod Pathol"},{"issue":"4","key":"10.1016\/j.modpat.2022.100010_bib28","doi-asserted-by":"crossref","first-page":"392","DOI":"10.1097\/LGT.0000000000000569","article-title":"Clinicopathologic diagnosis of differentiated vulvar intraepithelial neoplasia and vulvar aberrant maturation","volume":"24","author":"Day","year":"2020","journal-title":"J\u00a0Low Genit Tract Dis"},{"issue":"1","key":"10.1016\/j.modpat.2022.100010_bib29","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1097\/LGT.0000000000000572","article-title":"Diagnostic criteria for differentiated vulvar intraepithelial neoplasia and vulvar aberrant maturation","volume":"25","author":"Heller","year":"2021","journal-title":"J\u00a0Low Genit Tract Dis"},{"issue":"4","key":"10.1016\/j.modpat.2022.100010_bib30","doi-asserted-by":"crossref","first-page":"391","DOI":"10.1097\/PGP.0000000000000742","article-title":"Targeted molecular sequencing of recurrent and multifocal non-HPV-associated squamous cell carcinoma of the vulva","volume":"40","author":"Pors","year":"2021","journal-title":"Int J Gynecol Pathol"},{"issue":"3","key":"10.1016\/j.modpat.2022.100010_bib31","doi-asserted-by":"crossref","first-page":"415","DOI":"10.1038\/s41379-018-0141-4","article-title":"Time series analysis of TP53 gene mutations in recurrent HPV-negative vulvar squamous cell carcinoma","volume":"32","author":"Regauer","year":"2019","journal-title":"Mod Pathol"},{"key":"10.1016\/j.modpat.2022.100010_bib32","doi-asserted-by":"crossref","DOI":"10.1038\/s41379-022-01079-7","article-title":"HPV-independent, p53-wild-type vulvar intraepithelial neoplasia: a review of nomenclature and the journey to characterize verruciform and acanthotic precursor lesions of the vulva","author":"Parra-Herran","year":"2022","journal-title":"Mod Pathol"},{"issue":"3","key":"10.1016\/j.modpat.2022.100010_bib33","doi-asserted-by":"crossref","first-page":"404","DOI":"10.1038\/modpathol.2009.179","article-title":"Differentiated vulvar intraepithelial neoplasia contains Tp53 mutations and is genetically linked to vulvar squamous cell carcinoma","volume":"23","author":"Pinto","year":"2010","journal-title":"Mod Pathol"},{"issue":"2","key":"10.1016\/j.modpat.2022.100010_bib34","doi-asserted-by":"crossref","first-page":"238","DOI":"10.1111\/his.13205","article-title":"Human papillomavirus (HPV)-independent vulvar squamous cell carcinoma has a worse prognosis than HPV-associated disease: a retrospective cohort study","volume":"71","author":"McAlpine","year":"2017","journal-title":"Histopathology"},{"issue":"1","key":"10.1016\/j.modpat.2022.100010_bib35","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1053\/j.semdp.2020.09.004","article-title":"A\u00a0review of prognostic factors in squamous cell carcinoma of the vulva: evidence from the last decade","volume":"38","author":"Julia","year":"2021","journal-title":"Semin Diagn Pathol"},{"issue":"3","key":"10.1016\/j.modpat.2022.100010_bib36","doi-asserted-by":"crossref","first-page":"424","DOI":"10.1111\/his.14238","article-title":"Comparison of p53 immunohistochemical staining in differentiated vulvar intraepithelial neoplasia (dVIN) with that in inflammatory dermatoses and benign squamous lesions in the vulva","volume":"78","author":"Liu","year":"2021","journal-title":"Histopathology"},{"issue":"7","key":"10.1016\/j.modpat.2022.100010_bib37","doi-asserted-by":"crossref","first-page":"1131","DOI":"10.1038\/s41379-018-0021-y","article-title":"Differential expression patterns of GATA3 in usual and differentiated types of vulvar intraepithelial neoplasia: potential diagnostic implications","volume":"31","author":"Goyal","year":"2018","journal-title":"Mod Pathol"},{"issue":"4","key":"10.1016\/j.modpat.2022.100010_bib38","doi-asserted-by":"crossref","first-page":"324","DOI":"10.3390\/ph14040324","article-title":"Evaluation of immunohistochemical markers, CK17 and SOX2, as adjuncts to p53 for the diagnosis of differentiated vulvar intraepithelial neoplasia (dVIN)","volume":"14","author":"Dasgupta","year":"2021","journal-title":"Pharmaceuticals (Basel)"},{"key":"10.1016\/j.modpat.2022.100010_bib39","article-title":"Vulvar squamous cell carcinoma: comprehensive genomic profiling of HPV+ versus HPV- forms reveals distinct sets of potentially actionable molecular targets","volume":"4","author":"Williams","year":"2020","journal-title":"JCO Precis Oncol"},{"issue":"2","key":"10.1016\/j.modpat.2022.100010_bib40","doi-asserted-by":"crossref","first-page":"274","DOI":"10.1038\/s41379-021-00942-3","article-title":"Molecular landscape of vulvovaginal squamous cell carcinoma: new insights into molecular mechanisms of HPV-associated and HPV-independent squamous cell carcinoma","volume":"35","author":"Salama","year":"2022","journal-title":"Mod Pathol"}],"container-title":["Modern Pathology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0893395222000102?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0893395222000102?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T20:14:11Z","timestamp":1760213651000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S0893395222000102"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,2]]},"references-count":40,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2023,2]]}},"alternative-id":["S0893395222000102"],"URL":"https:\/\/doi.org\/10.1016\/j.modpat.2022.100010","relation":{},"ISSN":["0893-3952"],"issn-type":[{"value":"0893-3952","type":"print"}],"subject":[],"published":{"date-parts":[[2023,2]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"p53-Abnormal \u201cFields of Dysplasia\u201d in Human Papillomavirus\u2013Independent Vulvar Squamous Cell Carcinoma Impacts Margins and Recurrence Risk","name":"articletitle","label":"Article Title"},{"value":"Modern Pathology","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.modpat.2022.100010","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"Crown Copyright \u00a9 2022 Elsevier Inc. on behalf of the United States & Canadian Academy of Pathology.","name":"copyright","label":"Copyright"}],"article-number":"100010"}}