Single agent cisplatin chemotherapy in surgically resected vulvar cancer patients with multiple inguinal lymph node metastases.
OBJECTIVE
The aim of this study was to evaluate acute and long-term morbidity, recurrence rate, and overall survival in patients with multiple groin lymph node metastases treated with postoperative chemotherapy.


METHODS
Patients affected by FIGO stages III, IVA, and IVB (pelvic lymph nodes only) submitted to surgery were then treated with four cycles of cisplatin 100 mg/m(2) given 21 days apart. Toxicity, overall, and disease-free survival were evaluated.


RESULTS
Fourteen patients were evaluated. Median patients age was 58 (range 48-82). Median performance status was 0 (0-2). All patients completed the treatment. No treatment-related deaths occurred. Only two patients suffered from grade 4 neutropenia during chemotherapy. Three patients suffered from long-term severe lymphedema. Four patients suffered a disease recurrence. Three of these patients were subjected to surgery with no severe postoperative complications. Two of the latter patients are still alive. At a median follow-up of 57.5 months (range 23-79 months) actuarial 3-year overall survival and progression-free survival are 86% and 71%, respectively.


CONCLUSIONS
In patients affected by vulvar cancer with multiple lymph node metastases, radical surgery followed by chemotherapy is a feasible strategy, with an acceptable short- and long-term complication rate. Results in terms of overall survival and disease-free survival are promising. Furthermore, due to absence of local long-term tissue toxicity, this strategy allows physicians to surgically treat regional lymph node recurrence safely.
Bellati
Filippo
F
Department of Obstetrics and Gynecology, Campus Bio Medico University of Rome, Via Longoni, 83-00155 Rome, Italy.
Angioli
Roberto
R
Manci
Natalina
N
Angelo Zullo
Marzio
M
Muzii
Ludovico
L
Plotti
Francesco
F
Basile
Stefano
S
Panici
Pierluigi Benedetti
PB
D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery*; D002945:Cisplatin / Q000009:adverse effects / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000473:pathology / Q000601:surgery; D008207:Lymphatic Metastasis; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D014846:Vulvar Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery*
D000970:Antineoplastic Agents; D002945:Cisplatin