Introduction The primary objective was to determine the prognostic factors affecting progression-free and overall survival. The secondary objective was to determine the progression-free survival (PFS) and overall survival (OS) in vulvar cancer patients.

Methods We retrospectively reviewed the medical records of vulvar cancer patients at Siriraj Hospital between 2006 and 2020. Patient characteristics, surgical outcomes, pathological characteristics, and immunohistochemical (IHC) results: p16, p53, and PD-L1 were analyzed to predict the survival outcomes.

Results Of 104 vulvar cancer patients, prognostic factors that significantly correlated with worsening PFS were coexisting vulvar lesions, such as sclerosis and extramammary Paget’s disease (p=0.008), positive lymphovascular invasion (LVSI) (p=0.011), positive pelvic or paraaortic node metastases (p=0.042), and positive p53 status (p=0.046). Tumor size over 4 cm in diameter was significantly associated with worsening OS (p=0.001). The median PFS was 26.3 months, and the median OS was 44.7 months. The patients with positive p16 and negative p53 IHC had significantly better PFS and OS, p=0.004 and 0.025, respectively.

Conclusion/Implications Coexisting vulvar lesions, LVSI status, pelvic or paraaortic node metastases, and p53 status significantly affect PFS in vulvar cancer patients. Tumor size over 4 cm is negatively associated with OS.