Display options
Share it on

Oncol Lett. 2012 Oct;4(4):719-722. doi: 10.3892/ol.2012.831. Epub 2012 Jul 27.

Neoadjuvant chemoradiotherapy followed by surgery in locally advanced squamous cell carcinoma of the vulva.

Oncology letters

A Gaudineau, D Weitbruch, P Quetin, S Heymann, T Petit, P Volkmar, F Bodin, M Velten, J F Rodier

Affiliations

  1. Departments of Surgical Oncology and.

PMID: 23205089 PMCID: PMC3506666 DOI: 10.3892/ol.2012.831

Abstract

Alternative therapies have been sought to alleviate mutilation and morbidity associated with surgery for vulvar neoplasms. Our prime objective was to assess tumor absence in pathological vulvar and nodal specimens following neoadjuvant chemoradiotherapy in locally advanced vulvar neoplasms. Data were retrospectively collected from January 2001 to May 2009 from 22 patients treated with neoadjuvant therapy for locally advanced squamous cell carcinoma of the vulva. Neoadjuvant treatment consisted of inguino-pelvic radiotherapy (50 Gy) in association with chemotherapy when possible. Surgery occurred at intervals of between 5 to 8 weeks. The median age of patients at diagnosis was 74.1 years. All patients were primarily treated with radiotherapy and 15 received a concomitant chemotherapy. Additionally, all patients underwent radical vulvectomy and bilateral inguino-femoral lymphadenectomy. Tumor absence in the vulvar and nodal pathological specimens was achieved for 6 (27%) patients, while absence in the vulvar pathological specimens was only achieved for 10 (45.4%) patients. Postoperative follow-up revealed breakdown of groin wounds, vulvar wounds and chronic lymphedema in 3 (14.3%), 7 (31.8%) and 14 cases (63.6%), respectively. Within a median follow-up time of 2.3 years [interquartile range (IQR), 0.6-4.6], 12 (54.6%) patients experienced complete remission and 6 cases succumbed to metastatic evolution within a median of 2.2 years (IQR, 0.6-4.6), with 1 case also experiencing perineal recurrence. Median survival time, estimated using the Kaplan-Meier method, was 5.1 years (IQR, 1.0-6.8). We suggest that neoadjuvant chemoradiotherapy may represent a reliable and promising strategy in locally advanced squamous cell carcinoma of the vulva.

References

  1. Gynecol Oncol. 1995 Oct;59(1):51-6 - PubMed
  2. Gynecol Oncol. 2005 Dec;99(3):640-4 - PubMed
  3. Gynecol Oncol. 1991 Jul;42(1):9-21 - PubMed
  4. Gynecol Oncol. 1992 Oct;47(1):14-20 - PubMed
  5. Gynecol Oncol. 1996 Jun;61(3):321-7 - PubMed
  6. Int J Radiat Oncol Biol Phys. 1993 Aug 1;26(5):809-16 - PubMed
  7. Gynecol Oncol. 1991 Sep;42(3):197-201 - PubMed
  8. Int J Radiat Oncol Biol Phys. 2000 Jul 15;47(5):1235-44 - PubMed
  9. Gynecol Oncol. 1997 Aug;66(2):258-61 - PubMed
  10. Ann Plast Surg. 1997 Jun;38(6):563-76; discussion 577 - PubMed
  11. Gynecol Oncol. 2004 Jun;93(3):659-66 - PubMed
  12. Int J Radiat Oncol Biol Phys. 1988 Oct;15(4):901-6 - PubMed
  13. Gynecol Oncol. 1986 Sep;25(1):20-5 - PubMed
  14. Cancer. 1995 May 1;75(9):2289-94 - PubMed
  15. Am J Clin Oncol. 1987 Apr;10(2):171-81 - PubMed
  16. Int J Gynecol Cancer. 2009 May;19(4):745-51 - PubMed
  17. Int J Radiat Oncol Biol Phys. 1998 Aug 1;42(1):79-85 - PubMed
  18. Acta Oncol. 1993;32(6):657-61 - PubMed
  19. Crit Rev Oncol Hematol. 2012 Apr;82(1):25-39 - PubMed
  20. Int J Radiat Oncol Biol Phys. 2000 Nov 1;48(4):1007-13 - PubMed
  21. Acta Obstet Gynecol Scand. 1982;61(3):195-7 - PubMed
  22. Cancer. 1996 Apr 15;77(8):1472-8 - PubMed
  23. Int J Radiat Oncol Biol Phys. 2000 Sep 1;48(2):415-20 - PubMed
  24. Cancer. 1984 Nov 15;54(10):2056-61 - PubMed

Publication Types