Neoadjuvant and definitive chemotherapy or chemoradiation for stage III and IV vulvar cancer: A pooled Reanalysis

Eur J Obstet Gynecol Reprod Biol. 2017 May:212:115-118. doi: 10.1016/j.ejogrb.2017.03.030. Epub 2017 Mar 19.


Objectives and methods: A number of publications study the treatment of advanced vulvar cancer by neoadjuvant or definitive chemotherapy (CT) or chemoradiation (CRT); however, the reported survival rates vary widely. In a pooled reanalysis of the published data, we studied the factors influencing patients' survival.

Results: We included 97 patients with stage III and IV vulvar cancer of publications in our study. In the pooled reanalysis we found that neoadjuvant therapy plus surgery lead to significantly better 5YSR (73%) than definitive CRT (43%) alone. No significant difference was found between CRT (5YSR: 69%) and CT (77%, p=0.11) in the neoadjuvant setting. In addition, patients showing a positive response to CT or CRT had a better 5YSR (67% vs. 20%, p=0.001).

Conclusion: Neoadjuvant therapy plus surgery can improve survival of patients with advanced vulvar cancer.

Keywords: Chemoradiation; Lymph node metastasis; Neoadjuvant therapy; Vulvar cancer.

Publication types

  • Meta-Analysis

MeSH terms

  • Aged
  • Carcinoma, Squamous Cell / drug therapy*
  • Carcinoma, Squamous Cell / mortality
  • Carcinoma, Squamous Cell / radiotherapy*
  • Carcinoma, Squamous Cell / surgery
  • Female
  • Humans
  • Kaplan-Meier Estimate
  • Middle Aged
  • Neoadjuvant Therapy*
  • Neoplasm Staging
  • Vulvar Neoplasms / drug therapy*
  • Vulvar Neoplasms / mortality
  • Vulvar Neoplasms / radiotherapy*
  • Vulvar Neoplasms / surgery