Introduction/Background To evaluate the morbidity and mortality of the surgical management of vulvar cancer (VC).

Methodology We retrospectively included 192 patients diagnosed and treated for VC at the Salah Azaiez Institute between 1994 and 2022. We reviewed early and late post-operative complications and analyzed factors associated with surgical morbidity.

Results The mean age was 64.93± 13.817 years (range, 24–104 years). Surgery was a radical vulvectomy,hemivulvectoy, and pelvic exenteration in respectively 96.4%, 2.1%, and 1.6% of cases. Lymph node (LN) dissection was bilateral at 88.5%. Sentinal lymph node biopsy was performed in 5.7% of cases. Blood transfusion was necessary in 5 cases. The mean operative time was 124.71±45.738 mn and was significantly increased in stage pT2–3 (146.21±60.911 mn vs 120.89±41.566 mn in pT1, p=0.039) and with vaginal resection (201.67±102.453 vs 122.23 ± 40.961mn, p<0.0001). Postoperative complications were recorded in 77 cases. Medical complications were dominated by thromboembolic accidents in 4 cases (2.1%) and urinary infections in 2 cases (1%). Early surgical complications were dominated by Wound dehiscence in 7.8% of cases which was correlated to diabetes (28.6% vs 6.2%, p=0.003), neoadjuvant irradiation (33.3% vs 7.4%, p=0.097), advanced pT stage (17.2% in stage pT2–3 vs 6.1%, p=0.04), vaginal resection (33.3% vs 7.4%, p=0.018), wound infection (33.3% vs 5.2%, p<0.0001) and the operative time (123.45 mn vs 139.67mn, p=0.061). Rectal fistula occurred in 2 cases, and hematoma in 3 cases. Surgical revision was necessary in 5 cases (5.2%). Late surgical complications were dominated by lymphocyst in 7.8% of cases and lymphoedema in 9.9% of cases which was correlated to advanced pN stage (11.11% in stage pN2-N3 vs 9.7% in stage pN0-N1, p=0.011).

Conclusion The morbidity of the surgical management of VC should be evaluated in order to improve survival and reduce the median period of hospitalization.

Disclosures No potential conflict of interest