Radiation treatment in recurrent squamous cell cancer of the vulva.
OBJECTIVE
To evaluate the treatment and outcome of recurrent vulvar cancer.


METHODS
In a retrospective review of 26 women referred to the department of radiation oncology between 1982 and 1995, patient records were analyzed with respect to the findings at original surgery, the time to locoregional recurrence, the location of the recurrence, and the subsequent management and outcome.


RESULTS
Sixteen recurrences were managed with a combination of surgery and radiotherapy, and the remainder with radiation treatment, combined with chemotherapy in some cases. The overall survival for the entire cohort at 5 years was 22%. The 5-year survival for those with recurrence confined to the vulva (n = 13) was 46%, compared with 0% for those women with a recurrence located or extending beyond the vulva (p = 0.002). The local control rate was 34.6%.


CONCLUSIONS
Our results confirm the poor overall prognosis for this condition. In particular, they highlight the importance of the location of the recurrence as a prognostic indicator. Based on this review, we conclude that radiotherapy fields should encompass the region at risk if the intent is curative. Finally, low-dose palliation for groin node recurrence is ineffectual.
Hruby
G
G
Department of Radiation Oncology, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia. cmacleod@radonc.rpa.cs.nsw.gov.au
MacLeod
C
C
Firth
I
I
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy / Q000532:radiotherapy* / Q000601:surgery; D002423:Cause of Death; D015331:Cohort Studies; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy / Q000532:radiotherapy* / Q000601:surgery; D011879:Radiotherapy Dosage; D012189:Retrospective Studies; D014846:Vulvar Neoplasms / Q000188:drug therapy / Q000532:radiotherapy* / Q000601:surgery