Association between body mass index, obesity, and vulvar cancer recurrence

Objective: The objective of this paper is to study the association between obesity and tumor recurrence in patients with vulvar cancer. Methods: This is a retrospective study including vulvar cancer patients from 2003 to 2022. Our primary outcome was progression-free survival (PFS) stratified by status of obesity, defined as body mass index (BMI) >30.0 kg/m². Results: Overall, 48 patients were included in the study, with 32 (66.7%) diagnosed at early stages (I–II). The median BMI was 28.0 kg/m² [interquartile range 24.9–32.3 kg/m²]. There were 13 obese patients (27%), and the median follow-up time was 55 months [interquartile range 14–102]. Most patients (80%) were HPV-independent of human papilloma virus. Surgical intervention was the primary treatment modality for 88% (n = 42) of the cohort, and 26 patients (54%) received adjuvant chemoradiation. Disease recurrence was identified in 28 patients (58%). The median PFS was 68 months, and the median overall survival was 109 months. There was no difference in the median PFS between obese patients and non-obese patients (P = 0.370). In a Cox regression analysis, after adjusting for patient age, margin-free distance, and stage of disease, BMI was not associated with PFS hazard ratio 1.06 (0.99–1.12). Conclusion: Obesity is not associated with PFS in patients with vulvar cancer, and BMI might not be considered a risk factor for recurrence.