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445 Outcomes after radiotherapy for vulvar cancer
  1. Mark A Zahra
  1. Edinburgh Cancer Centre, Edinburgh, UK

Abstract

Introduction/Background Radiotherapy in vulvar cancer can be used either as radical treatment for inoperable cases or adjuvantly after a resection based on risk factors such as surgical margins and nodal status. This audit reviewed the outcomes of a group of patients who received radiotherapy for vulvar cancer and looked at the impact of known risk factors for recurrence.

Methodology The charts for a consecutive cohort of patients treated with radiotherapy at our institution for vulvar cancer were reviewed (group A= adjuvant, group B = radical) to identify the outcomes in terms of recurrence and disease free survival (DFS). The following risk factors: HPV status, lymphovascular invasion, tumour grade, nodal involvement and smoking history were assessed to see their impact on recurrence. Correlations were assessed using a Chi squared test with 2-tailed testing, p≤ 0.05 taken to show statistical significance.

Results A total of 93 cases (A=57, B=36) were included, with a median follow up of 43 months (IQR: 16–87), the median age was 64 years. Whole cohort 5-year DFS was 64.2% (A= 67.5%, B=58%). There were 41 (44%) recurrences (A= 43.9%, B=44.4%) with 27 recurrences within the radiotherapy field and 14 distant recurrences. The median time to recurrence was 12 months (IQR: 7–17), with an associated 80.5% disease related mortality and a median survival of 3 months from recurrence. Of the patients with known HPV status 38% were positive and 62% were negative. LVI, nodal status, grade and smoking history did not correlate with recurrence risk, but a positive HPV status had a strong negative correlation with recurrence (p=0.002).

Conclusion This cohort showed that a positive HPV status reduces the risk of recurrence after radiotherapy in both the adjuvant and radical settings.

Disclosures None

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