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

Abstract 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.