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Abstract
Introduction/Background The treatment of vulvar cancer with perineal involvement can be challenging due to its proximity to the anal sphincter. This study describes treatment patterns, complications, relative survival - (RS) and recurrence-free survival rates (RFS) in relation to treatment modality of this specific location of vulvar cancer in a Swedish cohort.
Methodology A retrospective population-based study of women with primary vulvar cancer treated at two tertiary referral hospitals and vulvar cancer centers in Sweden between 2012 and 2020. Demographic and clinical data were retrieved from the medical records.
Results In 571 women with primary vulvar cancer, 152 (29%) had tumors located in the perineum. Squamous cell carcinomas constituted 94% of these cancers. The majority of the women were treated with primary surgery, either alone (n=79, 52%, 2-year RS (87% (95% CI:79–96)), 2-year RFS 82% (95% CI:74–91)), or combined with adjuvant oncologic treatment (n=37, 24%, 2-year RS (59% (95% CI: 45–78)), 2-year RFS 48% (95% CI:34–68)). Definitive radio(chemo)therapy, (n=36, 24%, 2-year RS (44% (95% CI: 27–71)), 2-year RFS 33% (95% CI:21–53)) was most often used for stage IV disease, but also in 44% of stage II (n=7). Vulvar wound-related complications were common, though severe complications were rare. Fecal incontinence was reported in 3%. The overall recurrence rate was 21% with the lowest rate in stage I and in women treated with surgery alone but increased with increasing stage, addition of radiotherapy, and definitive radio(chemo)therapy.
Conclusion Although most perineal vulvar cancers were treated surgically, definitive radio(chemo)therapy seemed to be more widely used in perineal vulvar cancer. Complications, recurrence- and survival rates were comparable to previously published data involving all locations of vulvar cancer.
Disclosures No dislosures.
