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899 Node-positive carcinoma of vulva treated with curative-intent radiotherapy: reported outcomes from a large single Australian institution
  1. Julianne O’Shea1,
  2. Emma Link2,
  3. Pearly Khaw1,2,
  4. David Chang1,2,
  5. Krystel Tran1,2,
  6. Andrew Lim3 and
  7. Ming-Yin Lin1,2
  1. 1Department of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia
  2. 2Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Australia
  3. 3Radiation Therapy Services, Division of Radiation OncologyPeter MacCallum Cancer Centre, Melbourne, Australia


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.

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