291O - Outcomes of Vulvar Cancer (VC) patients (pts): Impact of clinico‑pathological factors and HPV status (291O)

Date 18 November 2017
Event ESMO Asia 2017 Congress
Session Gynaecological cancers
Topics Vulvar and Vaginal Cancers
Gynaecologic Malignancies
Pathology/Molecular Biology
Presenter Carolina Ortiz
Citation Annals of Oncology (2017) 28 (suppl_10): x86-x93. 10.1093/annonc/mdx663
Authors C. Ortiz1, V. Rodriguez Freixinos1, J. Hernandez-Losa2, L. FariÑas Madrid1, A. Gil‑ Moreno3, A. Pérez Benavente3, J.L. Sanchez‑iglesias3, B. Díaz-Feijo3, A. Garcia2, S. Franco-Camps3, S. Cabrera-Diaz3, R. Verges4, C. Viaplana5, G. Villacampa-Javierre5, R. Dienstmann5, A. Oaknin1
  • 1Medical Oncology Department, Vall d'Hebron University Hospital, 8035 - Barcelona/ES
  • 2Anatomical Pathology, Vall d'Hebron University Hospital, 08035 - Barcelona/ES
  • 3Gynaecology Department, Vall d'Hebron University Hospital, 8035 - Barcelona/ES
  • 4Radiation Oncology Department, Vall d'Hebron University Hospital, 8035 - Barcelona/ES
  • 5Oncology Data Science Group (odyssey), Vall d' Hebron Institute of Oncology (VHIO), 08035 - Barcelona/ES

Abstract

Background

Tumor size, resection margin and lymph node (LN) involvement are recognized prognostic factors in VC. We aimed to evaluate their impact in predicting recurrence and the potential association between HPV status and survival in VC pts.

Methods

Medical records from pts diagnosed with squamous VC pts at our institution between 2000 and 2016. HPV status was determined by multiplex PCR genotyping. The results of uni and multivariable logistic regression analyses are described.

Results

76 pts, with median age of 76 years (yr) (32-94) were identified. FIGO-2009 staging: 51 (67%) stage I-II, 22 (29%) stage III and 3 (4%) stage IV. HPV was positive in 11 (14.5%) pts (75% HVP-16). Most pts had surgery (97%) with median resection margin of 13 mm (2-33mm) and median invasion depth of 6 mm (0-40mm). Surgical groin staging was performed on 51 pts (67%; of these, sentinel only in 27% and inguinofemoral LN dissection in 73%). At median follow-up of 6 yr, 31 pts (41%) recurred (of these, 39% vulvar, 55% groins and 35% distant sites). Median 6 yr recurrence free survival (RFS) and overall survival rates were 64% (CI95% 51-81%) and 62% (CI95% 51-77%), respectively. In univariable models, tumor size (OR:1.05 for every 1 mm increase in size, p = 0.02) and LN + (OR:1.59 for every node, p = 0.05) associated with higher risk of recurrence. Multivariable analysis confirmed tumor size (OR:1.04, p = 0.13) as the strongest prognostic factor. HPV+ pts had superior RFS at 6-yr (80% vs. 64.5%, HR:0.7 p = 0.07) and a trend for lower risk of recurrence (27% vs. 46%, p = 0.32) compared to HPV-negative. At 1st recurrence, 20 pts (62%) underwent second surgery (followed by RT in 25%). These pts had median RFS after 1st recurrence of 24.7 months (CI95% 9.1m-NA) and 32% were disease-free at 4 yr.

Conclusions

Our data confirmed the prognostic value of tumor size and LN involvement in VC. HVP positivity was associated with trend for higher RFS and lower risk of recurrence. In our cohort, 1 every 3 pts with curative local therapy after 1st recurrence achieved disease control. Our findings warrant further validation in larger cohorts.

Clinical trial identification

Legal entity responsible for the study

N/A

Funding

None

Disclosure

All authors have declared no conflicts of interest.