Woelber L, et al. - In this subset analysis of the AGO-CaRE-1 study-a retrospective survey of treatment patterns and prognostic factors in vulvar cancer-researchers focused on the disease course with regard to localization of recurrence. They also studied the association of different recurrence sites. Inclusion of patients (pts) with primary VSCC (vulvar cancer), FIGO stage ≥1B treated in Germany from 1998 to 2008 in a centralized database (n = 1618) was done. The recurrence site highly determined the prognosis post-recurrence. For vulvar only, groins only, vulvar and groins, pelvic/distant, the hazard ratios (95% confidence interval) to die for pts with vs without recurrence at the same time were estimated to be 5.9 (4.3–8.2), 6.0 (3.0–10.2), 14.1 (7.6–26.4), and 21.2 (15.3–29.4), respectively. The development of second recurrences was seen in pts with isolated vulvar recurrence, resulting in an impaired prognosis.