Radiation treatment in recurrent squamous cell cancer of the vulva

Abstract

Purpose: To evaluate the treatment and outcome of recurrent vulvar cancer. Methods and Materials: 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%. Conclusion: 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.