Introduction/Background Pelvic exenteration (PE) may be the only curative treatment option in locally advanced primary or recurrent vulvar cancer (VC), a rare disease mainly affecting elderly women. For this reason, surgeons may be reluctant to perform (PE) when indicated. Data on morbidity and mortality after PE in VC is limited. Our objective was to examine postoperative outcomes after PE in women with VC.

Methodology This descriptive, observational study included all consecutive women with primary or recurrent vulvar cancer treated by PE between 2000 and 2022 at Karolinska University Hospital, Stockholm, Sweden. Data were extracted from hospital records. Postoperative complications were categorized according to the Clavien-Dindo classification (CDC) and stratified by age (<70 and ≥70 years). Survival was graphically displayed as Kaplan-Meier curves and differences in survival times by treatment at the recurrent or primary setting tested with the log-rank test.

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Abstract #738 Figure 1

Distribution of complications according to the Clavien-Dindo classification for women <70 and =70 years of age. (A) Within 30 days post-operatively, (B) Within 31–90 days post-operatively, (C) Within 91–180 days post-operatively.

Results Twenty-eight women with a median age of 65 years were identified. Posterior PE was most prevalent (43%, n=12) followed by anterior (32%, n=9) and total (25%, n=7) PE. Within 30 days after surgery, 82% (n=23) developed at least one complication, of these 36% (n=10) were CDC grade III, predominantly comprising infections. The 30-day mortality was 4% (n=1). There were no distributional differences in postoperative complications by age. After a median follow up of 44 months (min. 3, max. 136), the 5-year recurrence-free survival was 55% (95% Confidence Interval (CI) 29–75) and the overall survival 68% (95% CI 44–84). There were no significant differences in survival by primary or recurrent disease.

Conclusion PE in women with VC seems to result in acceptable morbidity rates and a low risk of mortality. Albeit the small sample size did not allow for detailed analysis, our results indicate that PE may be a valid treatment option even in elderly women, both in the primary and recurrent setting.

Disclosures None.