Survival Trends Following Surgical Management in Carcinoma Vulva Patients During Covid 19 Pandemic: A Tertiary Care Hospital Study.

Background: Vulval cancers account for 0.25% of new cancer cases and 0.2% of new deaths of all sites worldwide making it an uncommon malignancy according to Global cancer Statistics 2020. Covid 19 for two years made the situation worse. Proper investigations, adjuvant therapy and follow-up for complications was a challenge. The present study is a prospective observational study on treatment outcome of Carcinoma Vulva at a tertiary care hospital during COVID-19 pandemic.

Methods: Twenty patients of non-metastatic carcinoma vulva were recruited over 22 months of Covid 19 pandemic. Surgery was individualized as wide local excision or radical vulvectomy. Inguinal nodes were addressed as per location of tumour. All cases were followed 2 monthly with virtual/physical meetings till 18 months. Changes in accordance with ongoing COVID 19 pandemic were made in carcinoma vulva diagnostic tests, preoperative work up, intra operatively, post-op complication management and follow-up.

Results: The mean age of the study participants was 59.85 ± 10.32 years. In the sample population analysed, menopause was experienced on average at the age of 49.47 ± 4.29 years. Thirty five percent (7) of patients had positive lymph nodes during surgery. All 3 patients who died had positive lymph nodes. Also, all three had no taken adjuvant treatment advised to them by the tumour board. Phased resumption of complex surgeries and adaptation to better PPEs helps in the staff acclimatization to the new normal of operating under constant threat of COVID. In our study, 85% patients were disease free at 18 months follow-up. This is similar to outcomes of carcinoma vulva cases in non-Covid times. There was no difference amongst re-exploration, morbidity and mortality rates for cancer surgeries in COVID and non-COVID years highlighting the fact that effective implementation of cancer surgery and peri operative care guidelines is crucial for good surgical outcomes.

Conclusion: This study sheds light on good prognosis of carcinoma vulva with proper treatment and follow-up. Covid times were managed with virtual meets and talking with local practitioners. Screening programs, rural awareness camps and more studies are needed in this field.

Supplementary Information: The online version contains supplementary material available at 10.1007/s13224-023-01935-9.