Lichen Sclerosis is Associated With a High Rate of Local Failure After Radio(chemo)therapy for Vulvar Cancer

Area of Science:

• Oncology
• Radiation Oncology
• Gynecologic Oncology

Background:

• Radio(chemo)therapy is a cornerstone in vulvar cancer management for both adjuvant and definitive treatment settings.
• Limited data exist on outcomes following modern radio(chemo)therapy protocols for vulvar cancer.
• Identifying prognostic factors is crucial for optimizing treatment and patient outcomes.

Purpose of the Study:

• To evaluate disease outcomes in vulvar cancer patients treated with radio(chemo)therapy.
• To specifically investigate the impact of lichen sclerosis on local control after radio(chemo)therapy.

Main Methods:

• A cohort of 109 consecutive vulvar cancer patients treated between 2013-2020 were analyzed.
• Patients received either definitive or postoperative radio(chemo)therapy.
• Outcomes including local control, survival, and morbidity were assessed using Kaplan-Meier statistics and prognostic factor analysis.

Main Results:

• A 5-year local control rate of 58.9% was observed, with 42% of patients experiencing recurrence.
• Lichen sclerosis was identified as an independent risk factor for local recurrence (HR 3.89).
• Patients with lichen sclerosis had significantly lower local control rates compared to those without.

Conclusions:

• Radio(chemo)therapy is vital for vulvar cancer, yet local relapse rates remain substantial.
• Pre-existing lichen sclerosis is a significant predictor of local recurrence.
• These findings necessitate tailored surveillance strategies for patients with lichen sclerosis.