A large 10-year series from a single-site institution in the United Kingdom of vulva carcinoma: An audit on adherence of United Kingdom guidelines and overall survival.

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e17572 Background: We audited if our 10-year-series in our Institution's Vulva Carcinoma adhered with the Royal College of Obstretrician and Gynaecology (RCOG) Guidelines. In United Kingdom, from 2014, the guidelines states 1) Wide local excision of primary tumor with minimum 15mm of disease free tissue is often sufficient 2) Sentinel lymph node (LN) biopsy can be done in unilateral tumor of less than 4cm and if no clinical suspicion of LN involvement 3) In bilateral tumors, only ipsilateral groin node surgery needs to be done initially. Contralateral LN dissection may be required if ipsilateral nodes are positive 4) Groin node dissection should be omitted in stage Ia SCC, BCC, verrucous tumor and melanoma 5) Patient unfit for surgery can be treated with primary radiotherapy (RT) Methods: All Vulva Carcinoma Cancer coded from 2009-2017 were mined from database. Results: Total of 121 patients. Mean age 74 years old (36-104 years old). Squamous cell carcinoma = 105, Melanoma = 5, Adenoid cyst = 1, Paget's = 2, Verrucous = 2, Basal cell carcinoma = 2, Sarcoma = 1, Adenocarcinoma = 3. All stages of Vulva cancer were 100% compliant with RCOG guidelines, except for Stage 1C, which achieved 62.5% compliance. Out of 104 vulva cancer, 32 had no indications for surgical groin LN assessment (16 patients in 1a disease + 16 patients stage 4 disease) 72 had indications and were offered surgical groin LN assessment. However, 45 out of 72 (62.5%) had surgical groin LN assessment. 12 out of 72 (16.7%)were declined due to co morbidities. 15 out of 72 (20.8%) did not wish surgical groin node assessment. Conclusions: WLE were offered to all vulva patients. Clear margins were achieved in 97%. RT was offered to 2% of patients as there was not possible to achieve clear margin with re-excision. All eligible patients with indications for groin LN surgical assessment had offered nodal surgery. Patients with multiple comorbidity and not fit for surgery due to their advanced staging were treated with RT alone, chemo/RT and best supportive care. Overall survival was 205.7 weeks. Stage Surgery (Sx) Radiotherapy (RT) Sx+RT Sx+chemo RT+chemo BSC Ia 16 Ib 59 II 1 1 III 6 3 5 1 3 2 IV 1 3 2 SCC unknown staging 2 Non SCC 16

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