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799 Risk factors for recurrence and survival in vulvar cancer: retrospective analysis
  1. Gerard Molina1,
  2. Sergi Fernández-González1,
  3. Rodrigo Guevara1,
  4. Judit Alemany1,
  5. Mireia Castilla1,
  6. Álvaro Cañizares1,
  7. Samuel Pérez1,
  8. August Vidal2,
  9. Xavier Matias-Guiu2,
  10. Juan Carlos Torrejon-Becerra1,
  11. Carlos Ortega1,
  12. Marc Barahona1,
  13. Lola Martí1 and
  14. Jordi Ponce1
  1. 1Gyneacologic Department, University Hospital of Bellvitge (IDIBELL), University of Barcelona, Barcelona, Spain
  2. 2Department of Pathology, University Hospital of Bellvitge (IDIBELL), University of Barcelona, Barcelona, Spain

Abstract

Introduction/Background Vulvar cancer is a rare tumour accounting for only 0.3% of all new cancers. Despite its low frequency, 40% of patients experience recurrences and the survival rate after 5 years is 69.6%. The aim of this study was to analyse the risk factors associated with recurrence and survival.

Methodology Retrospective analysis of patients who underwent primary surgery for early stage vulvar squamous cell carcinoma between January 2010 and 2023. Factors such as grade of differentiation, tumour focality, lymphovascular space invasion, perineural invasion, stromal invasion, tumour size, resection margins, groin lymph node involvement, vulvar intraepithelial neoplasia and lichen sclerosus were evaluated in relation to disease-free survival and overall survival.

Results Our study included 58 patients, with an average follow-up time of 73 months. Of these, 40% experienced recurrences and 50% died. The mean time to second recurrence was 15 months, compared to 81 months for the first recurrence (p value= 0.00). All patients (7/7) who had a second recurrence died due to vulvar cancer. There were no significant differences in the risk of recurrence for the prognostic factors analysed. However, there was a significant difference (p=0.034) in survival for patients with stromal invasion greater than 5mm.

In the multivariate analysis, lichen sclerosus in the surgical specimen was identified as the only independent risk factor for recurrence, with a hazard ratio (HR) of 3.9 (95%CI, 1.13–13.79). Additionally, the independent risk factors for survival were perineural invasion with a HR of 4.12 (95%CI, 1.22–13.90) and stromal invasion greater than 5mm with a HR of 2.65 (95%CI, 1.01–6.93).

Conclusion Our results differ from some described in literature such as tumour resection margins correlation with poor overall survival, among others. This may be due to the low number of patients with this rare disease. Future prospective trials are needed to establish these prognostic factors.

Disclosures No disclosures.

Abstract 799 Table 1

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