Introduction/Background Vulvar carcinoma is uncommon, accounting for <5% of all gynaecological malignancies.1–2 Surgery is the mainstay of treatment for early-stage disease whilst definitive chemoradiotherapy (CRT) is considered for locally advanced disease to avoid the morbidity of extensive surgery3–5. Node-positive disease is often associated with a poor prognosis. This study investigates outcomes of patients with node-positive vulvar carcinoma treated with radiotherapy (RT) +/- chemotherapy with curative intent over a 20-year period, in terms of patterns of failure, failure-free survival (FFS) and overall survival OS).

Methodology Patients were eligible if they had a histological diagnosis of node-positive vulvar carcinoma and received curative intent radiotherapy +/- chemotherapy either as primary treatment or in the adjuvant setting following definitive surgery between 2000 – 2019 at the Peter MacCallum Cancer Centre. Eligible patients were retrieved from the gynae-oncology unit’s prospective database where clinical, histopathological; treatment and follow-up data were collected for analysis.

Results Eighty-eight women met the inclusion criteria. Median age was 65 years (range 33–90). Sixty-two patients received surgery & adjuvant RT. Of these, 57(92%) patients had concomitant chemotherapy. Twenty-four patients received definitive CRT and 2 received definitive RT alone. Median dose to gross inguinal nodes (n=43) was 57Gy (range 34–60) and median dose to gross primary disease was 62Gy (n=25) (range 34–64). Median follow-up was 10.8 years (range 1.2–21.4). At 5 years, OS was 54% for the entire cohort; 57% in the patients receiving adjuvant RT and 46% in the definitive group. Forty-four/88 patients (50%) from the entire group (n=88) relapsed, of which 13/44 (30%) failed at the primary site alone. Disease control at the primary site and nodes was achieved in 50/88 patients (57%).

Conclusion Loco-regional control in patients with node-positive vulvar carcinoma treated with chemoradiotherapy, with or without surgery is reasonable, with a trend towards improved outcomes with a combination of surgery and radiotherapy.

Disclosures No disclosures.