561P When to treat the pelvis in node-positive vulvar cancer: Results from the AGO-VOP.2 QS vulva study

The population at risk for pelvic disease in vulvar cancer is poorly described. This results an overtreatment of a considerable proportion patients with groin-positive disease. In this retrospective, multicenter analysis, 306 primary node-positive squamous cell carcinoma (VSCC) after surgical groin staging treated 33 gynecologic oncology centers Germany between 2017- 2019 were analyzed regard to treatment, nodal involvement and prognosis. majority had locally restricted tumors (T1b/T2; 292/306; 95.4%) median tumor diameter 32 mm (2-110mm). Nodal status the groin(s) was as follows: 23.9% (73/306) pN1a, 23.5% (72/306) pN1b, 20.4% (62/306) pN2a/b, 31.9% (97/306) pN2c/pN3 (TNM system version 6). Only 35.6% (109/306) received LAE – 39.4% unilaterally 60.6% bilaterally; observed 18.5%. None one intranodal metastasis or 2 metastases <5mm showed involvement. Taking only more inguinal into account, rate 25%. total, adjuvant RT applied 64.4% (197/306). half who positive nodes pelvis (50%, 10/20 patients); 41.9% (122/291 patients) experienced recurrent died. histologically confirmed LAE, distant recurrences most frequently (7/20 recurrences). case detected metastases, low. These data no longer justify uncritical treatment - neither surgery nor radiotherapy- cancer.