The aim of this study was to evaluate acute and long-term morbidity, recurren ce rate, and overall survival in patients with multiple groin lymph node metasta ses treated with postoperative chemotherapy. Patients affected by FIGO stages II I, IVA, and IVB (pelvic lymph nodes only) submitted to surgery were then treated with four cycles of cisplatin 100 mg/m2 given 21 days apart. Toxicity, overall, and disease-free survival were evaluated. Fourteen patients were evaluated. Me dian patients age was 58 (range 48-82). Median performance status was 0 (0-2). All patients completed the treatment. No treatmentrelated deaths occurred. Only two patients suffered from grade 4 neutropenia during chemotherapy. Three patie nts suffered from long-term severe lymphedema. Four patients suffered a disease recurrence. Three of these patients were subjected to surgery with no severe po stoperative complications. Two of the latter patients are still alive. At a medi an follow-up of 57.5 months (range 23-79 months) actuarial 3-year overall sur vival and progression-free survival are 86%and 71%, respectively. 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 l ong-term complication rate. Results in terms of overall survival and disease-f ree survival are promising. Furthermore, due to absence of local long-term tiss ue toxicity, this strategy allows physicians to surgically treat regional lymph node recurrence safely.
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