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83 Role of adjuvant radiotherapy in the management of vulvar cancer: experience of the Tunisian center
  1. Souha Massoudi1,
  2. Sabrine Tbessi2,
  3. Sonia Zaied3,
  4. Haifa Hajabdallah2,
  5. Dalia Yazid2,
  6. Rim Zanzouri2,
  7. Nadia Bouzid2,
  8. Samia Kanoun2 and
  9. Sameh Tebra2
  1. 1Department of Radiotherapy Hospital of Farhat Hached Sousse, Sousse, Tunisia
  2. 2Departement of Radiotherapy Hospital Farhat Hached Sousse, Sousse, Tunisia
  3. 3Department of Medical Oncology Monastir, Monastir, Tunisia


Introduction/Background Vulvar cancer is a rare tumor whose prognosis depends on early treatment. The study aimed to evaluate the epidemioclinical and anatomopathological aspects of vulvar cancer, to review the different treatment modalities with the therapeutic results and to identify the prognostic factors influencing the evolution of this tumor.

Methodology Descriptive and analytical study included 38 patients treated with adjuvant radiotherapy, from 1995 to 2020, for vulvar cancer in the oncological radiotherapy department at CHU Farhat Hached in Sousse.

Results The median age was 64 years [44–85]. The mean tumor size was 41mm [6–150]. The tumor was classified as stage I, II, and III in 47.3%, 42.1%, and 10.5% of cases. A total vulvectomy was performed for (98%) of patients with a bilateral inguinal dissection in 76.3% of cases. The sentinel technique was performed for two patients (5%). All patients had adjuvant radiotherapy, but only two had concomitant chemotherapy. After a median follow-up of 55 months, 24 patients are in complete remission (63.2%). We noted a local and regional recurrence in respectively 23.7% and 13.2% of cases. Two patients had distant bone progression. In the analytical study, overall survival (OS) was 72% at five years. The 5-year local and regional disease-free survival was 76% and 87%, respectively. In univariate analysis, the factors associated with OS were tumor size (p=0.02), excision quality (p=0.000), and age (p=0.04). The quality of excision (p=0.001) and inguinal dissection (p=0.05) were factors associated with the local disease-free survival. Furthermore, regional disease-free survival was influenced by the presence of lymph node invasion and the quality of excision. None of these criteria was an independent factor of survival in multivariate analysis.

Conclusion Vulvar cancer requires early diagnosis to consider adequate and less invasive treatment with advances in both surgical and radiotherapy techniques becoming more conservative with better tolerance and quality of life.

Disclosures No conflict of interest.

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