Abstract 601P
Background
As vulvar and vaginal cancers are rare malignancies, treatment is extrapolated from the cervical cancer field, in which concurrent chemoradiation is used. Thus, further studies are necessary to evaluate whether surgery, radiotherapy (RT) or combined chemoradiotherapy (CRT) will benefit patients the most.
Methods
A retrospective chart review was conducted on patients diagnosed with vulvar or vaginal cancer in 2000-2017. Descriptive statistics were used to compare survival outcomes, including overall survival (OS), disease-free survival (DFS), and cancer-specific survival (CSS), using hazard ratios (HR) between surgery, RT only, and CRT.
Results
This study included 688 patients with either vulvar (N=560, 81%) or vaginal cancer (N=128, 19%). Median age of diagnosis was 68 (27-98) years. For patients who received curative RT, median OS (mOS) was 100.4 months with concurrent chemotherapy vs 66.6 months without for vaginal cancer (p=0.31); for vulvar, mOS 63.8 with chemo vs 46.3 months without (p=0.75). In multivariate survival analysis, vulvar cancer was associated with more likelihood of death (HR: 1.50, p=0.042) compared to vaginal cancer. For vulvar cancer patients who received RT (N=224, 40%; HR: 0.80, p=0.25), CRT (N=100, 18%; HR: 0.80, p=0.30) was not associated with statistical OS improvement. Patients with vulvar cancer who received ≥5 weeks of chemotherapy had better OS (HR: 0.78, p=0.038) and DFS (HR: 0.71, p=0.004) vs <5 weeks of treatment. There was no difference in OS (HR: 1.30, p=0.45 ), DFS (HR: 1.19, p=0.55), or CSS (HR: 1.44, p=0.35) between those who had adjuvant vs primary RT. Patients with vaginal cancer who received RT (N=100, 78%; HR: 0.75, p=0.40) did not show statistically significant OS (N=51, 40%; HR: 1.31, p=0.41), DFS (HR: 1.05, p=0.87), or CSS (HR: 1.26, p=0.65) improvement with CRT. For these patients, the weeks of chemotherapy delivered (<5 vs ≥5 weeks) had no effect on OS (HR: 0.95, p=0.86), DFS (HR: 1.44, p=0.20), or CSS (HR: 1.12, p=0.77).
Conclusions
In this retrospective study, CRT was not associated with significant improvements in survival for patients with vulvar or vaginal cancer compared to RT. Future studies investigating novel therapies to treat these cancers are needed to improve patient outcomes.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.