{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,13]],"date-time":"2025-12-13T06:51:50Z","timestamp":1765608710385,"version":"build-2065373602"},"reference-count":35,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2020,1,17]],"date-time":"2020-01-17T00:00:00Z","timestamp":1579219200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>The most important prognostic factor in vulvar cancer is inguinal lymph node status at the time of diagnosis, even in locally advanced vulvar tumors. The aim of our study was to identify the risk factors of lymph node involvement in these women, especially the impact of lichen sclerosis (LS). We conducted a retrospective population-based cross-sectional study in two French referral gynecologic oncology institutions. We included all women diagnosed with a primary invasive vulvar cancer. Epithelial alteration adjacent to the invasive carcinoma was found in 96.8% (n = 395). The most frequently associated was LS in 27.7% (n = 113). In univariate analysis, LS (p = 0.009); usual type VIN (p = 0.04); tumor size &gt;2 cm and\/or local extension to vagina, urethra or anus (p &lt; 0.01), positive margins (p &lt; 0.01), thickness (p &lt; 0.01) and lymphovascular space invasion (LVSI) (p &lt; 0.01) were significantly associated with lymph node involvement. In multivariate analysis, only LS (OR 2.3, 95% CI [1.2\u20134.3]) and LVSI (OR 5.6, 95% CI [1.7\u201318.6]) remained significantly associated with positive lymph node. LS was significantly associated with older patients (p = 0.005), anterior localization (p = 0.017) and local extension (tumor size &gt; 2 cm: p = 0.001). LS surrounding vulvar cancer is an independent factor of lymph node involvement, with local extension and LVSI.<\/jats:p>","DOI":"10.3390\/jcm9010250","type":"journal-article","created":{"date-parts":[[2020,1,17]],"date-time":"2020-01-17T07:39:02Z","timestamp":1579246742000},"page":"250","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Associated Lichen Sclerosis Increases the Risk of Lymph Node Metastases of Vulvar Cancer"],"prefix":"10.3390","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9353-6036","authenticated-orcid":false,"given":"Yohann","family":"Dabi","sequence":"first","affiliation":[{"name":"Facult\u00e9 de m\u00e9decine de Cr\u00e9teil UPEC\u2014Paris XII. Service de Gyn\u00e9cologie-Obst\u00e9trique et M\u00e9decine de la Reproduction. Centre Hospitalier Intercommunal de Cr\u00e9teil. 40 Avenue de Verdun, 94000 Cr\u00e9teil, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marie","family":"Gosset","sequence":"additional","affiliation":[{"name":"Facult\u00e9 de m\u00e9decine de Cr\u00e9teil UPEC\u2014Paris XII. Service de Gyn\u00e9cologie-Obst\u00e9trique et M\u00e9decine de la Reproduction. Centre Hospitalier Intercommunal de Cr\u00e9teil. 40 Avenue de Verdun, 94000 Cr\u00e9teil, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sylvie","family":"Bastuji-Garin","sequence":"additional","affiliation":[{"name":"Universit\u00e9 Paris Est, A-TVB DHU, LIC EA4393, 94010 Cr\u00e9teil, France"},{"name":"AP-HP, H\u00f4pital Henri Mondor, Service de Sant\u00e9 Publique, 94010 Cr\u00e9teil, France"},{"name":"AP-HP, H\u00f4pital Henri Mondor, Unit\u00e9 de Recherche Clinique (URC Mondor), 94010 Cr\u00e9teil, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rana","family":"Mitri-Frangieh","sequence":"additional","affiliation":[{"name":"Service d\u2019anatomopathologie, Centre Hospitalier Intercommunal de Cr\u00e9teil. 40 Avenue de Verdun, 94000 Cr\u00e9teil, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sofiane","family":"Bendifallah","sequence":"additional","affiliation":[{"name":"Service de Gyn\u00e9cologie-Obst\u00e9trique et M\u00e9decine de la Reproduction, H\u00f4pital Tenon (AP-HP), 4 rue de la Chine, 75020 Paris, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emile","family":"Darai","sequence":"additional","affiliation":[{"name":"Service de Gyn\u00e9cologie-Obst\u00e9trique et M\u00e9decine de la Reproduction, H\u00f4pital Tenon (AP-HP), 4 rue de la Chine, 75020 Paris, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bernard Jean","family":"Paniel","sequence":"additional","affiliation":[{"name":"Facult\u00e9 de m\u00e9decine de Cr\u00e9teil UPEC\u2014Paris XII. Service de Gyn\u00e9cologie-Obst\u00e9trique et M\u00e9decine de la Reproduction. Centre Hospitalier Intercommunal de Cr\u00e9teil. 40 Avenue de Verdun, 94000 Cr\u00e9teil, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roman","family":"Rouzier","sequence":"additional","affiliation":[{"name":"Department of Surgery, Institut Curie, Paris, Saint-Cloud, France; EA 7285; Universit\u00e9 Versailles-Saint-Quentin-en-Yvelines, 35 Rue Dailly, 92210 Saint-Cloud, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bassam","family":"Haddad","sequence":"additional","affiliation":[{"name":"Facult\u00e9 de m\u00e9decine de Cr\u00e9teil UPEC\u2014Paris XII. Service de Gyn\u00e9cologie-Obst\u00e9trique et M\u00e9decine de la Reproduction. Centre Hospitalier Intercommunal de Cr\u00e9teil. 40 Avenue de Verdun, 94000 Cr\u00e9teil, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9149-1663","authenticated-orcid":false,"given":"Cyril","family":"Touboul","sequence":"additional","affiliation":[{"name":"Facult\u00e9 de m\u00e9decine de Cr\u00e9teil UPEC\u2014Paris XII. Service de Gyn\u00e9cologie-Obst\u00e9trique et M\u00e9decine de la Reproduction. Centre Hospitalier Intercommunal de Cr\u00e9teil. 40 Avenue de Verdun, 94000 Cr\u00e9teil, France"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2020,1,17]]},"reference":[{"key":"ref_1","unstructured":"(2018, November 01). 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