Introduction/Background Around 30% of vulvar cancer cases are diagnosed at advanced stage. The aim of our analysis was to assess the survival rates in patients with locally advanced vulvar cancer (LAVC) undergoing primary (chemo)radiation (CRT).
Methodology Data on patients with squamous cell LAVC (AJCC stage II-IV) referred to our Institution, undergone primary CRT between January 2016 and July 2022 were evaluated.
Results Among 55 patients, 7 (12.7%) patients had no concomitant chemotherapy because considered unfit. Twelve (21.8%) patients had stage II disease, 18 (32.7%), 2 (3.6%) and 23 (41.8%) had stage III, IVA, IVB disease, respectively. The median age was 71 years, median tumor size was 50 mm, 43 (78.2%) patients had positive lymph nodes. Radiation treatment consisted of 1.8/2 Gy daily for 5 days, repeated weekly. The median radiation dose to gross disease was 70 Gy. Concurrent chemotherapy consisted of weekly Cisplatin (N=28), Cisplatin and 5-Fluorouracil (N=17) or Carboplatin (N=3). Eighteen (32.7%) patients had complete clinical response to CRT (cCR), 23 (41.8%) had partial clinical response (cPR), 14 (25.5%) had stable disease or progression (SD/PD). Twenty (36.4%) patients had following radical surgery (cCR=2, cPR=17, PD=1).
The median follow-up time was 17 months. Twenty-nine (52.7%) patients had disease progression, 23 (41.8%) patients dead of disease, 6 dead with no evidence of disease.
Overall survival (OS) at 3 years was 80% for patients with cCR, 26.5% for patients with cPR, 0% for patients with SD/PD (p<0.001). After adjusting for age and clinical stage, age>75 years (HR 2.8; 95% CI: 1.2–6.2; p=0.014), cPR (HR 3.8; 95% CI: 1.1–13.8; p=0.041) and SD/PD (HR 57.5; 95% CI:12.2–270.3; p<0.001) were independently associated with poor survival rates.
Conclusion In patients with LAVC, complete clinical response to CRT is associated with high survival rates. Advanced age, partial or absent clinical response to CRT are associated with very poor survival.
Disclosures Authors have nothing to declare
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