Postoperative radiotherapy in the management of vulvar cancer.

Background: Vulvar cancer is a rare tumor whose prognosis depends on early treatment.

Aim: The study aimed to evaluate the role of adjuvant radiotherapy (RT) in the treatment of vulvar cancer and to identify the prognostic factors influencing the tumor evolution.

Methods: descriptive and analytical study included 38 patients treated by adjuvant RT, during the period from 1995 to 2020, for vulvar cancer in the oncological radiotherapy department of Farhat Hached University Hospital in Sousse.

Results: All patients underwent adjuvant RT. After a median follow-up of 55 months, 24 patients are in complete remission (63.2%). We noted local and regional recurrences in 23.7% and 13.2% of cases. Two patients had distant bone progression. Overall survival (OS) was 72% at five years and 51% at ten years. The 5-year local (SSRL) and regional (SSRR) recurrence-free survival was 76% and 87%, respectively. In univariate analysis, the factors associated with OS were the size of the tumor (p=0.02), the quality of excision (p=0.000) and age (p=0.04). The quality of excision (p = 0.001) and inguinal dissection (p = 0.05) was associated with SSRL. In addition, those influencing the SSRR were lymph node invasion and the quality of excision.

Conclusion: vulvar cancer requires early diagnosis in order to consider less invasive treatment with advances in RT techniques.