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Treatment of Inoperable Vulvar Cancer: Where We Come From and Where Are We Going
  1. Pedro Martinez-Castro, MD,
  2. Andrés Poveda, MD,
  3. José Luis Guinot, MD and
  4. Lucas Minig, MD, PhD, MBA
  1. * From the Departments of Gynecology,
  2. Medical Oncology, and
  3. Radiation Oncology, Valencian Institute of Oncology, Valencia, Spain.
  1. Address correspondence and reprint requests to Lucas Minig, MD, PhD, MBA, Department of Gynecology, Clinical Area of Gynecologic Oncology, Valencian Institute of Oncology, C/del Profesor Beltrán Baguena 8 46009, Valencia, Spain. E-mail: miniglucas{at}


Abstract Vulvar cancer is a rare disease affecting elderly women that is commonly treated with surgery, radiation, and chemotherapy. When tumors compromise the urethra and the anus, or when it is in the groin lymph nodes, radiotherapy, chemotherapy, or both are necessary after surgery.

The treatment of locally advanced vulvar cancer has suffered significant changes though the recent decades. So far, the best sequence of treatment is not known: surgery, chemotherapy, or radiotherapy. The radical surgeries usually need a long recovery term both in the region of the vulva and in the area of the groin lymph nodes. When it is performed, convalescence can delay other treatments, such as radiotherapy and chemotherapy. On the other hand, the use of radiotherapy and chemotherapy as a first step treatment can result in a complete elimination of the disease in at least 30% of the cases or substantial reduction of its size, allowing less extensive surgery. Therefore, the historical evolution of locally advanced vulvar cancer is reviewed.

  • Vulvar cancer
  • Pelvic exenteration
  • Neoadjuvant chemotherapy
  • Concurrent chemoradiation

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  • The authors declare no conflicts of interest.