Objectives Evaluate the clinical results of patients with locally advanced vulva malignant neoplasia treated with radiotherapy or neoadjuvant chemotherapy.
Methods Retrospective analysis of the medical records of patients who were followed up at the Oncology Gynecology center of Santa Marcelina Hospital in São Paulo between 2008 and 2018 and who underwent neoadjuvant radiotherapy or chemotherapy for vulvar neoplasia.
Results In the study period, 55 patients were diagnosed with vulvar neoplasia, 21 (38.18%) submited to neoadjuvant radiotherapy and 15 (27.27%) underwent neoadjuvant chemotherapy too. Of the 21 patients treated with neoadjuvant therapy, 1 had histopathological diagnosis of adenocarcinoma and the other 20 of squamous cell carcinoma. Twelve patients (57.14%) underwent surgery afterwards: 10 patients (47.61%) had a radical vulvectomy with bilateral lymphadenectomy and 2 patients (9.52%) had a hemivulvectomy with bilateral lymphadenectomy. In the follow-up of the patients who underwent neoadjuvant therapy, 4 patients (19%) presented persistence of disease and 5 (23.8%) local recurrence. Of the patients submitted to neoadjuvant therapy, 11 (52.38%) died and 7 (33.3%) lost follow-up. The majority of patients were in stage II (FIGO 2009).
Conclusions The evolution of vulvar neoplasia results in the involvement of structures close to the vulva, like urethra and anal region. Thus, as most patients at the time of diagnosis already have a locally advanced disease, neoadjuvant therapy decreases the tumor load and reduces the need for extensive surgeries, also decreasing surgical morbidity. In this study, the complete control rate was approximately 57.2% with neoadjuvant therapy, demonstrating the benefit of this type of treatment.
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