Treatment outcomes of curative radiotherapy in patients with vulvar cancer: results of the retrospective KROG 1203 study.
OBJECTIVE
We evaluated the prognostic factors and clinical outcomes of 56 patients with vulvar cancer treated with curative radiotherapy (RT) or concurrent chemoradiotherapy.


METHODS
Overall survival (OS) and disease-free survival (DFS) were assessed retrospectively. Prognostic factors evaluated included age, International Federation of Gynecology and Obstetrics (FIGO) stage, TNM classification, tumor size, treatment modality, RT duration, and RT field. The association between the tumor human papillomavirus (HPV) status and survival was analyzed in 35 patients.


RESULTS
During the median follow-up of 2.8 years (range, 0.3 to 18.9 years), 21 patients (37.5%) experienced treatment failure. Fifteen patients (27%) had local failure: nine (16%) local failure only, three (5%) locoregional failure, two (4%) local and distant failure, and one (2%) locoregional and distant failure. Of 56 patients, seven (13%) had persistent disease at the first follow-up at 2 months and all but one died within a year after completing RT. The 5-year OS and DFS were 51.6% and 44.0%, respectively. In multivariate analysis, clinical size ≥3 cm predicted a poor prognostic factor for DFS (p = 0.040) and age (≥70 years) was poor prognostic for DFS (p = 0.032) and OS (p = 0.048). Patients with HPV-positive tumors tended to have better 5-year OS and DFS, but the differences were not significant statistically.


CONCLUSIONS
Clinical size ≥3 cm was a significant prognostic factor for DFS. However, age was the most important prognostic factor for DFS and OS in patients treated with curative RT. Further studies are needed to determine which treatment should be considered for old age ≥70 years.
Proton Therapy Center, National Cancer Center, Goyang, Korea.
Youngkyong
Y
Kim
Proton Therapy Center, National Cancer Center, Goyang, Korea.
Joo-Young
JY
Kim
Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Ja Young
JY
Kim
Department of Radiation Oncology, Korea University Medical Center, Korea University College of Medicine, Seoul, Korea.
Nam Kwon
NK
Lee
Department of Radiation Oncology, Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea.
Jin Hee
JH
Kim
Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea.
Yong Bae
YB
Kim
Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Young Seok
YS
Kim
Department of Radiation Oncology, Cheil General Hospital and Women's Healthcare Center, Dankook University College of Medicine, Seoul, Korea.
Juree
J
Kim
Department of Radiation Oncology, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea.
Yeon-Sil
YS
Kim
Department of Radiation Oncology, Korea University Medical Center, Korea University College of Medicine, Seoul, Korea.
Dae Sik
DS
Yang
Proton Therapy Center, National Cancer Center, Goyang, Korea.
Yeon-Joo
YJ
Kim
Radiotherapy; Risk factor; Survival; Vulvar cancer