title: Neoadjuvant and definitive chemotherapy or chemoradiation for stage III and IV vulvar cancer: A pooled Reanalysis.
abstract: OBJECTIVE
  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).
  
  
  CONCLUSIONS
  Neoadjuvant therapy plus surgery can improve survival of patients with advanced vulvar cancer.
authors.affiliation: Evangelisches Krankenhaus Köln Kalk, Buchforststrasse 2, D-51103 Köln, Germany. Electronic address: dr.forner@gmx.de.
authors.forename: Dirk Michael
authors.initials: DM
authors.lastname: Forner
authors.affiliation: Universitäts-Frauenklinik Köln, Kerpener Str. 34, D-50931 Köln, Germany.
authors.forename: Peter
authors.initials: P
authors.lastname: Mallmann
mesh_terms: D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy* / Q000401:mortality / Q000532:radiotherapy* / Q000601:surgery; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009367:Neoplasm Staging; D014846:Vulvar Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000532:radiotherapy* / Q000601:surgery
keywords: Chemoradiation; Lymph node metastasis; Neoadjuvant therapy; Vulvar cancer