Purpose : Therapeutic outcomes of patients with advanced vulvar cancer are generally poor and multimodality treatment is now considered the treatment of choice.We report a pilot study on neoadjuvant therapy followed by radical surgery for patients with locally advanced squamous cell carcinoma of the vulva.

Method : 16 patients of  squamous cell carcinoma of the vulva, stage II–IVA were treated with neoadjuvant therapy.10 patients out of 16  received neoadjuvant chemoradiotherapy upfront,2 patients received hypofractionated radiotherapy and 4 patients received initial neoadjuvant chemotherapy followed by evaluation for preoperative chemoradiotherapy.After a period of 4–6 weeks,patients were evaluated for surgery.Out of 16 patients, 13 patients showed response amenable for surgery.1 patient refused for surgery and 12 patients underwent surgery. The remaining 3 patients completed the chemoradiotherapy course to the total dose.

 Results : An objective response was observed in 81.25% (10 out of 12 patients ). One patient refused for surgey and the pathologic complete response rate (pCR)  was seen in 4/12(33.33%), pathologic microscopic foci in 2/12 (16.66%) and pathological macroscopic partial response was in 6/12 patients(50%).5 of 9 patients (55.55%) with biopsy proven inguinal lymph node metastases showed no residual lymph node in the specimen.

Conclusions : Neoadjuvant chemoradiotherapy followed by radical surgery seems to be effective and promising strategy for locoregionally advanced squamous cell carcinoma of vulva.The present article details a single institution study aimed to evaluate the efficacy of these approaches in reducing the need for more radical surgery in locally advanced vulvar cancer