A Case of Systemic Chemotherapy With Paclitaxel/Cisplatin Followed by Wide Local Vulvectomy in Pelvic Lymph Nodes-Related Stage IVB Vulvar Cancer

TL;DR

A patient with advanced vulvar cancer showed complete tumor regression after chemotherapy, allowing for successful surgery and improved quality of life.

Contribution

Demonstrates the efficacy of paclitaxel-cisplatin chemotherapy in stage IVB vulvar cancer and supports tailored surgical approaches.

Findings

Systemic chemotherapy with paclitaxel-cisplatin led to near-complete tumor regression in a stage IVB vulvar cancer patient.

Pathological examination confirmed no residual carcinoma after surgery, indicating a complete response to chemotherapy.

Tailored surgical strategies can reduce complications and prioritize quality of life in advanced vulvar cancer treatment.

Abstract

Multimodality treatments, including chemotherapy, radiation, and surgery, have been evaluated to reduce the extent of resection and morbidity in patients with advanced vulvar cancer. Here, we report the case of a 55-year-old woman diagnosed with advanced vulvar cancer with inguinal and pelvic lymph node metastasis. She exhibited cancerous labia, which were entirely covered with ulcerated and exophytic lesions of squamous cell carcinoma, and underwent systemic chemotherapy consisting of combined paclitaxel-cisplatin. After eight cycles of this regimen, the tumors had nearly regressed, and we performed a wide local vulvectomy with a plastic musculocutaneous flap. Pathological examination revealed no residual carcinoma in the excised labia, indicating that the chemotherapy elicited a pathological complete response. The paclitaxel-cisplatin regimen may provide sufficient efficacy for selected patients with stage IVB vulvar cancer. In addition, surgical strategies should be tailored to avoid complications associated with extensive surgery and more emphasis should be placed on the patient’s expected quality of life.

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