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Poster session 09

601P - Treatment patterns and outcomes of patients with locally advanced vulvar or vaginal cancer in British Columbia

Date

10 Sep 2022

Session

Poster session 09

Topics

Clinical Research

Tumour Site

Vulvar and Vaginal Cancers

Presenters

Emily Leung

Citation

Annals of Oncology (2022) 33 (suppl_7): S235-S282. 10.1016/annonc/annonc1054

Authors

E. Leung1, C. Tremblay1, D. Liao2, L. Huang3, S.Z. Sun3, J. Ko4

Author affiliations

  • 1 Medicine, University of British Columbia, V6T 1Z3 - Vancouver/CA
  • 2 Medicine, University of Toronto, M5S 1A8 - Toronto/CA
  • 3 Mathematics And Statistics, University of the Fraser Valley, V2S7M7 - Abbotsford/CA
  • 4 Medical Oncology Dept., Abbotsford Regional Hospital and Cancer Centre, V2S 0C2 - Abbotsford/CA

Resources

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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.

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