ESTRO 2022 - Abstract Book

S1147

Abstract book

ESTRO 2022

performed in every patient. The optimal therapeutic approach of iunguinal nodes was chosen due to preoperative imaging. One women received adjuvant, postoperative radiotherapy. During long follow-up, two patients had recurrence of vulvar cancer (regional and/or distant), three of them were diagnosed with lung cancer, one developed advanced anal cancer . One of the patient had no follow-up after treatment. Conclusion Vulvar cancer is usually diagnosed in older women. Some of them might be treated before other cancers, including gynaecological malignancies. Synchronous (diagnosed within 6 months) cervical and vulvar cancer may occur especially in women with persistent HPV infection. In our data, time intervals between treatment of cervical and vulvar cancer were very long. It may suggest that vulvar cancer development was based on lichen sclerosus or lichen planus. Follow-up events show that lung cancer is still a most common cancer worldwide and it’s screening should be performed even during diagnostic and therapeutic process of other types of cancer.

PO-1352 Prognostic value of HPV in a cohort of patients affected by adenocarcinoma of the uterine cervix

G. Malfatti 1 , C. Laliscia 1 , N. Coccia 2 , R. Mattioni 1 , T. Fuentes 1 , R. Morganti 3 , F. Paiar 1

1 Azienda Ospedaliera Universitaria Pisana, Unità Operativa Radioterapia, Pisa, Italy; 2 Azienda Universitaria Pisana, Unità Operativa Radioterapia, PIsa, Italy; 3 University of Pisa, Department of Clinical and Experimental Medicine, Section of Statistics, Pisa, Italy Purpose or Objective The aim of this study is to evaluate the impact of human papilloma virus (HPV) status in the clinical outcome of patients affected by adenocarcinoma of the uterine cervix treated with surgery followed by concurrent chemo-radiotherapy (CCRT) +/- brachyteraphy (BT). Materials and Methods We retrospectively evaluated 39 patients (median age 52 years, range 33-75 years) with FIGO (IB2-III) stage cervical adenocarcinoma, who were treated in our Institution, from January 2012 to December 2020; 29 patients (74%) were HPV (mostly HPV 16 or HPV 18) associated adenocarcinoma subtype (HPVA) and 10 patients (26%) were HPV not associated (NHPVA). Twenty-one patients (54%) received combined neoadjuvant chemotherapy of taxane and platinum, with or without anthracycline. All the women underwent surgery (type II-III radical hysterectomy with bilateral pelvic lymphadenectomy) followed by adjuvant pelvic RT (45-50.4Gy in 25-28 daily fractions) and 23 women (59%) received concomitant chemotherapy (weekly cisplatinum 40mg/m2). Sequential vaginal high-dose rate (HDR)-BT boost, up to a dose of 10Gy in 2 fractions of 5Gy, was delivered in 20 patients (51%). Pelvic RT was performed with a 6-15 MV beam using four- field conformal technique or Volumetric Modulated Arc Therapy (VMAT). Vaginal HDR-BT was delivered using a 192 Ir source, HDR afterloader, with a vaginal applicator set. Results Two-years and five years overall survival (OS) were 92% and 73%, and two-years and five years progression free survival (PFS) were 72% and 59%. At log rank test analysis, HPVA patients had a significant lower risk of death (p=0.004), as well as in the same cohort there was a trend for a lower risk of progression (p=0.098).

Conclusion Adenocarcinomas of the uterine cervix consist of a large heterogenous group of tumours, with about 35% correlated to HPV infection. The prognosis of these malignancies is worse than for other histologies. As shown in other organs, in our study HPV status significantly affects prognosis. In conclusion, HPV status in cervical cancer may be a useful prognostic biomarker before treatment.