该研究的目的是评估局部晚期鳞状细胞外阴癌（LAVC）患者接受前期放化疗（CRT）治疗后是否进行手术的生存率和手术相关毒性。 CRT 是不可切除的局部晚期鳞状细胞外阴癌 (LAVC) 患者的主要治疗方法，然后在肿瘤残留的情况下进行手术。AJCC II-IV 期鳞状细胞外阴癌患者转诊至 Fondazione Policlinico Universitario Agostino Gemelli 的妇科肿瘤科I.R.C.C.S.包括从 2016 年 1 月到 2023 年 2 月，由前期 CRT 管理的患者。共纳入 63 名患者，21 名 (33%) 对 CRT 完全缓解 (cCR)，26 名 (41%) 部分缓解 (cPR)，1 名 (2%) ) 疾病稳定 (cSD)，15 名 (24%) 出现疾病进展 (cPD)。在整个人群中，cPR/SD 和 cPD 与 PFS (p < 0.001) 和总生存 (OS) 降低 (p < 0.001) 相关，p16 表达与 PFS (p < 0.001) 和 OS (p = 0.001) 改善相关）。在 CRT 后出现临床残留病的患者中，与接受其他治疗的患者相比，23 名接受手术的患者的 PFS (p = 0.003) 和 OS (p = 0.003) 得到改善。八名 (35%) 患者出现严重（≥ III 级）术后并发症；外阴和腹股沟伤口裂开/感染是最常见的并发症；一名 (4%) 患者在术后死亡。存在病理残留病的患者的 PFS (p = 0.013) 和 OS (p = 0.034) 较差。对 CRT 的临床反应和 p16 表达强烈预测 LAVC 中的生存。残余疾病的手术可能与提高生存率有关，但并发症发生率很高。病理残留病与高复发率和低生存率相关。版权所有 © 2024。由 Elsevier Inc. 出版。

The aim of the study was to assess the survival rates and surgery-related toxicity in patients with locally advanced squamous cell vulvar cancer (LAVC) managed by upfront chemoradiation (CRT) with/without following by surgery. CRT is the primary treatment for patients with unresectable locally advanced squamous cell vulvar carcinoma (LAVC), followed by surgery in case of residual tumor.Patients with AJCC stage II-IV squamous cell vulvar carcinoma referred to Gynecologic Oncology Unit at Fondazione Policlinico Universitario Agostino Gemelli I.R.C.C.S. from January 2016 to February 2023, managed by upfront CRT, were included.63 patients were included, 21 (33 %) had complete response (cCR) to CRT, 26 (41 %) had partial response (cPR), 1 (2 %) stable disease (cSD), 15 (24 %) had disease progression (cPD). In the whole population, cPR/SD and cPD were associated with reduced PFS (p < 0.001) and overall survival (OS) (p < 0.001), p16 expression was associated with improved PFS (p < 0.001) and OS (p = 0.001). Among patients with clinical residual disease after CRT, 23 patients undergoing surgery experienced improved PFS (p = 0.003) and OS (p = 0.003) compared to those receiving other treatments. Eight (35 %) patients experienced severe (grade ≥ III) postoperative complications; vulvar and groin wound dehiscence/infection were the most common complications; one (4 %) patient died in the postoperative. Patients with pathological residual disease experienced worse PFS (p = 0.013) and OS (p = 0.034).Clinical response to CRT and p16 expression strongly predict survival in LAVC. Surgery for residual disease might be associated with improved survival but is burdened by high rates of complications. Pathologic residual disease correlates with high recurrence rates and poor survival.Copyright © 2024. Published by Elsevier Inc.