Role of radiotherapy in the management of vulvar cancer: Recommendations of the French society for radiation oncology

Chargari, Cyrus; Petit, A.; Escande, Alexandre; Peignaux, Karine; Lafond, C.; Peiffert, D.; Hannoun-Lévi, J.-M.; Durdux, C.; Haie-Méder, Christine

doi:10.1016/j.canrad.2021.08.014

“…Multivariate analysis suggested that tumor stage, tumor size, and lymph node status were independent prognostic factors affecting patients' OS. In addition, the French Society of Radiation Oncology clearly states that the main factors affecting the postoperative prognosis of patients with vulvar cancer include lymph node involvement, tumor stage, and patient age [17]. Our cohort was analyzed by multivariate COX regression after PSM analysis, and lymph node surgery was also an independent factor affecting patients' OS and DSS; however, postoperative radiotherapy was not an independent in uencing factor in patients with vulvar squamous cell carcinoma.…”

Section: Discussionmentioning

confidence: 92%

“…When the lesion diameter was less than 2 cm, the lymph node metastasis rate was about 23%, while when the lesion diameter was more signi cant than 2 cm, the lymph node metastasis rate was as high as 47% [19]. Adjuvant radiotherapy has been shown to signi cantly prolong the overall survival of patients with advanced disease [17,20]. In a retrospective analysis of 54 vulvar cancers by S C Han 1 et al, adjuvant radiotherapy was found to signi cantly improve disease-speci c survival (P=0.03) and overall survival (P=0.04) in patients with locally advanced vulvar cancer [21].…”

Section: Discussionmentioning

confidence: 99%

Prognostic value of postoperative radiotherapy in patients with vulvar squamous carcinoma: findings based on the SEER database

Li

¹

,

Li

²

,

Wang

³

2022

Preprint

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Introduction: The role of postoperative radiotherapy in treating squamous cell carcinoma of the vulva remains controversial. This study evaluated the effect of radiotherapy on the survival of patients with postoperative squamous cell carcinoma of the vulva.Methods： Clinical and prognostic information on patients diagnosed with vulvar squamous cell carcinoma from 2010 to 2015 was collected from the Surveillance, Epidemiology, and Prognosis (SEER) database. A propensity score matching (PSM) approach was used to balance the differences in clinicopathological characteristics between groups. The impact of postoperative radiotherapy on overall survival (OS) and disease-specific survival (DSS) was assessed.Results： The study included 3629 patients with squamous cell carcinoma of the vulva, of whom 767 (21.1%) underwent postoperative radiotherapy. After propensity score matching, multivariate analysis showed that Age, M stage, tumor size, and lymph node surgery were independent prognostic factors affecting patient survival. Postoperative radiotherapy improved patients' overall survival and disease-specific survival. Further subgroup survival analysis showed that overall survival was significantly improved among patients who received radiotherapy in patients with Grade III, IV, AJCC stage III, N1, lymph node metastasis, large tumor diameter, and those who received chemotherapy.Conclusion: Postoperative radiotherapy may provide a survival benefit for patients with squamous cell carcinoma of the vulva, especially for AJCC stage III, lymph node metastases, large tumor diameter, and those receiving postoperative chemotherapy.

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“…When the lesion diameter was less than 2 cm, the lymph node metastasis rate was about 23%, while when the lesion diameter was more signi cant than 2 cm, the lymph node metastasis rate was as high as 47% [19]. Adjuvant radiotherapy has been shown to signi cantly prolong the overall survival of patients with advanced disease [17,20]. In a retrospective analysis of 54 vulvar cancers by S C Han 1 et al, adjuvant radiotherapy was found to signi cantly improve disease-speci c survival (P = 0.03) and overall survival (P = 0.04) in patients with locally advanced vulvar cancer [21].…”

Section: Discussionmentioning

confidence: 99%

The role of postoperative radiotherapy in patients with vulvar squamous carcinoma: findings based on the SEER database

Wang

¹

,

Wang

²

,

Sun

³

2022

Preprint

0

View full text Add to dashboard Cite

Introduction: The role of postoperative radiotherapy in treating squamous cell carcinoma of the vulva remains controversial. This study evaluated the effect of radiotherapy on the survival of patients with postoperative squamous cell carcinoma of the vulva.Methods： Clinical and prognostic information on patients diagnosed with vulvar squamous cell carcinoma from 2010 to 2015 was collected from the Surveillance, Epidemiology, and Prognosis (SEER) database. A propensity score matching (PSM) approach was used to balance the differences in clinicopathological characteristics between groups. The impact of postoperative radiotherapy on overall survival (OS) and disease-specific survival (DSS) was assessed.Results： The study included 3629 patients with squamous cell carcinoma of the vulva, of whom 767 (21.1%) underwent postoperative radiotherapy. After propensity score matching, multivariate analysis showed that Age, M stage, tumor size, and lymph node surgery were independent prognostic factors affecting patient survival. Postoperative radiotherapy improved patients' overall survival and disease-specific survival. Further subgroup survival analysis showed that overall survival was significantly improved among patients who received radiotherapy in patients with Grade III, IV, AJCC stage III, N1, lymph node metastasis, large tumor diameter, and those who received chemotherapy.Conclusion: Postoperative radiotherapy may provide a survival benefit for patients with squamous cell carcinoma of the vulva, especially for AJCC stage III, lymph node metastases, large tumor diameter, and those receiving postoperative chemotherapy.

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“…22,23,32,40 Retrospective data showed the possibility to perform a highly focused irradiation boost to the tumor while sparing uninvolved parts of the vulva with interventional RT (brachytherapy). 52,53 A prospective trial will assess the safety and efficacy of intratumoral diffusing alpha radiation emitters for the treatment of vulva cancer (Clin-icalTrials.gov identifier: NCT04761146). Several concomitant chemotherapy regimens have been tested.…”

Section: Chemoradiation For Inoperable Tumorsmentioning

confidence: 99%

Vulvar Carcinoma: Standard of Care and Perspectives

Chargari,

Wasserman,

Gabro

et al. 2024

JCO

4

0

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PURPOSE Treatment of vulvar carcinoma (VC) is challenging. The objectives of this review were to describe for clinicians the epidemiologic and clinical aspects of VC, the standard of care in terms of primary local treatment and systemic therapies, and the recent innovations and perspectives emerging from translational research in immuno-oncology. DESIGN We conducted a comprehensive review outlying the clinical aspects and biologic background of vulvar cancer, highlighting modern treatment strategies on the basis of a personalized approach. RESULTS Epidemiologic data showed a recent rise in incidence of VC, attributed to human papillomavirus. Surgery is the mainstay of primary treatment, but multimodal approaches are frequently required in the presence of adverse prognosis histopathologic factors. Chemoradiation is indicated when organ-sparing surgery is not feasible. However, inability to achieve high locoregional control rates in advanced cases and the morbidity associated with local treatments are still key issues. Recent clinical data showed the benefit of individualized strategies combining organ-sparing surgical strategies, less invasive lymph node staging procedures, and refinement in radiotherapy modalities. Among the most important research area, there is a sound rationale for testing modern systemic approaches such as immune checkpoint inhibitors in selected patients with recurrent and/or metastatic tumors. Although no specific data exist for VC, the role of supportive care and post-treatment rehabilitation strategies is also crucial. CONCLUSION There are still insufficient studies dedicated to patients with VC. Public health programs for prevention, screening, and early diagnosis are required, and clinical research should be strengthened to provide high-quality clinical evidence and improve patients' oncologic and functional outcomes.

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Role of radiotherapy in the management of vulvar cancer: Recommendations of the French society for radiation oncology

Cited by 7 publications

References 25 publications

Prognostic value of postoperative radiotherapy in patients with vulvar squamous carcinoma: findings based on the SEER database

Prognostic value of postoperative radiotherapy in patients with vulvar squamous carcinoma: findings based on the SEER database

The role of postoperative radiotherapy in patients with vulvar squamous carcinoma: findings based on the SEER database

Vulvar Carcinoma: Standard of Care and Perspectives

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