Adjuvant radiotherapy and local recurrence in vulvar cancer – a subset analysis of the AGO-CaRE-1 study

Woelber L, Prieske K, Eulenburg Cz, Corradini S, Petersen C, Bommert M, Blankenstein T, Hilpert F, de Gregorio N, Iborra S, Sehouli J, Ignatov A, Hillemanns P, Fuerst S, Strauss HG, Baumann K, Beckmann M, Mustea A, Mahner S, Jaeger A (2021)

Publication Type: Journal article

Publication year: 2021

Journal

Gynecologic Oncology Elsevier

DOI: 10.1016/j.ygyno.2021.11.004

Abstract

Background: The impact of adjuvant radiotherapy (RT) to the vulva with regard to prognosis and local recurrence in patients with vulvar squamous cell cancer (VSCC) is poorly described. Patients and methods: In the AGO-CaRE-1 study 1618 patients with primary VSCC FIGO stage ≥ IB, treated between 1998-2008, were documented. In this retrospective subanalysis, 360 patients were included based on the following criteria: nodal involvement (pN+), known RT treatment and known radiation fields. Results: The majority had pT1b/pT2 tumors (n=299; 83.1%). In 76.7%, R0 resection was achieved. 57/360 (15.8%) N+ patients were treated with adjuvant RT to the groins/pelvis and 146/360 (40.5%) received adjuvant RT to the vulva and groins/pelvis. 157/360 (43.6%) patients did not receive any adjuvant RT. HPV status was available in 162/360 patients (45.0%), 75/162 tumors were HPV+(46.3%), 87/162 (53.7%) HPV-. During a median follow-up of 17.2 months, recurrence at the vulva only occurred in 25.5% of patients without adjuvant RT, in 22.8% of patients with adjuvant RT to groins/pelvis and in 15.8% of patients with adjuvant RT to the vulva and groins/pelvis respectively. The risk reducing effect of local RT was independent of the resection margin status. 50% disease free survival time (50% DFST) indicated a stronger impact of adjuvant RT to the vulva in HPV+ compared to HPV- patients (50% DFST 20.7 months vs. 17.8 months). Conclusion: Adjuvant RT to the vulva was associated with a lower risk for local recurrence in N+ VSCC independent of the resection margin status. This observation was more pronounced in patients with HPV+ tumors in comparison to HPV– tumors.

Authors with CRIS profile

Matthias Beckmann Lehrstuhl für Geburtshilfe und Frauenheilkunde

Involved external institutions

Klinikum der Universität München DE Germany (DE) Universitätsklinikum Hamburg-Eppendorf (UKE) DE Germany (DE) University of Groningen / Rijksuniversiteit Groningen NL Netherlands (NL) Kliniken Essen-Mitte DE Germany (DE) Krankenhaus Jerusalem DE Germany (DE) Universitätsklinikum Ulm DE Germany (DE) Universitätsklinikum Aachen (UKA) DE Germany (DE) Charité - Universitätsmedizin Berlin DE Germany (DE) Universitätsklinikum Magdeburg A.ö.R. DE Germany (DE) Medizinische Hochschule Hannover (MHH) / Hannover Medical School DE Germany (DE) Universitätsklinikum Halle (Saale) DE Germany (DE) Universitätsklinikum Bonn DE Germany (DE)

How to cite

APA:

Woelber, L., Prieske, K., Eulenburg, C.z., Corradini, S., Petersen, C., Bommert, M.,... Jaeger, A. (2021). Adjuvant radiotherapy and local recurrence in vulvar cancer – a subset analysis of the AGO-CaRE-1 study. Gynecologic Oncology. https://doi.org/10.1016/j.ygyno.2021.11.004

MLA:

Woelber, Linn, et al. "Adjuvant radiotherapy and local recurrence in vulvar cancer – a subset analysis of the AGO-CaRE-1 study." Gynecologic Oncology (2021).

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