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Abstract
Introduction Patients with advanced vulvar cancer that are considered inoperable can be cured with (chemo)radiation. We present a single institution experience with treatment outcomes and factors associated with survival.
Methods A retrospective cohort study of patients with proven carcinoma of the vulva diagnosed from 2011 to 2020 at Oslo University Hospital (Norway) is presented. Data were collected from the hospital radiation registry and medical records.
Results A total of 45 patients with inoperable vulvar cancer were included. Median age at diagnosis was 75 years (range 30–91). Forty-four patients were diagnosed with squamous cell carcinoma, one patient had adenocarcinoma. Equal number of cases belonged to stage II and III (40% each) of the FIGO 2021 classification. Fourteen patients (31.1%) had verified lymph node metastases. Fourteen patients also received cisplatin. Thirty-one patients (68.9%) received external beam radiotherapy only, the remaining received a combination of external beam and brachytherapy. Median total tumor dose (EQD2) was 70.1 Gy (range 58.9–80.6). Thirty-three patients presented with ECOG 0–1 at start of radiotherapy, the remaining 12 had ECOG 2. Twenty-one patients (46.7%) experienced recurrence of the cancer, of these 19 recurred in the vulvar region. Median time to progression was 6.0 months. Median overall survival for the whole cohort was 35.0 months (range 1.9–139.3). ECOG 0–1, concomitant cisplatin and use of brachytherapy was significantly associated with improved survival.
Conclusion/Implications Carefully selected patients with good performance status can experience long-term survival after chemoradiation for vulvar cancer. Quality of life should be monitored in future prospective studies.
