Neoadjuvant chemotherapy followed by radical surgery in patients affected by vaginal carcinoma

BackgroundRadiotherapy represents the standard treatment for patients affected by FIGO stage II vaginal cancer. Several authors have suggested that neoadjuvant chemotherapy followed by radical surgery might be a valid treatment option in patients affected by cervical cancer. The objective of this study was to analyse the feasibility and results obtained by neoadjuvant chemotherapy followed by surgery in patients affected by invasive vaginal cancer with paravaginal tissue involvement not reaching the pelvic side wall.MethodsEleven patients affected by FIGO stage II vaginal cancer were treated with paclitaxel 175mg/m2 and cisplatin 75mg/m2 every 21days for three courses followed by radical surgery.ResultsAll patients were subjected to the 3 planned chemotherapy courses. Three (27%) patients achieved a complete clinical response and seven (64 %) patients achieved a partial clinical response. All patients were subjected to radical hysterectomy and vaginectomy. At a median follow up of 75months two (18%) patients suffered a disease recurrence and one of these died of disease.ConclusionsNeoadjuvant chemotherapy followed by radical surgery is a feasible therapeutic strategy with good short- and long-term results. In women affected by vaginal cancer, a larger series reporting the result of this therapeutic strategy or the results obtained by surgery alone will aid physicians to choose the best therapeutic strategy for each individual patient.