Value Of Radiotherapy In The Management Of Paget'S Disease Of The Vulva: A Retrospective Study Of 31 Patients

Introduction/Background Surgical treatment is mutilating and resection often results in involved margins. As a consequence, local recurrences are frequent after surgery. Methodology Retrospective study of patients with vulvar Paget9s disease treated in our hospital between 1993 and 2018. Results Thirty-one consecutive patients with vulvar Paget9s disease were included, whereof twenty patients were irradiated in the primary or recurrent setting. Radiotherapy on the vulva and perineum was performed at a median dose of 60 Gy in fractions of 2 Gy. The median follow-up after radiotherapy was 75 months. Eight (26%) patients underwent as primary treatment radiotherapy only. Only one (13%) had a recurrence (after four months) and was operated. Fifteen (48%) patients had surgery as only primary treatment; five (33%) of them had a recurrence. Four of these had, after 3 or 4 surgical interventions, radiotherapy for recurrence. Only one of these 4, had a relapse after 85 months. Eight (26%) patients had as primary treatment surgery followed by adjuvant radiotherapy (due to positive margins), one (13%) of these recurred and died of disease. Conclusion Surgery is the most commonly used therapy for vulvar Paget9s disease, even though it is difficult to excise the disease adequately and often multiple surgeries are necessary. According to our experience, radiotherapy is a good adjuvant treatment option in patients with vulvar Paget9s disease with positive resection margins. Moreover, in our experience, primary radiotherapy seemed to be a safe alternative to surgery, that can prevent patients with Paget9s disease of the vulva to undergo mutilating and often repeated surgery. Disclosure Nothing to disclose