634 The Surgical Resectability After The Induction Chemotherapy for Locally Advanced Carcinoma of Vulva

Objective: to determine the effect of pre-op chemotherapy, to assess the clinical and surgico-pathological response for patients with locally advanced vulvar cancer. Patients and Methods: Between January 1983 and December 2003, 104 patients were sujected to preoperative chemotherapy for locally advanced inoperable Carcinoma Vulva. All these patients were staged according to the guidelines of FIGO. Diagnosis was confirmed by histopathology. The treatment protocal adopted was three courses of pre-operative chemotherapy of either [BMMF = 23] Bleomycin (D1 & D3), Methotrexate (D3), Mitomycin (D1&3) and 5 Flurouracil Cream for local application, or [CMF = 81Cyclophosphamide Methotrexate 5 Flurouracil regimen and clinically assessed for the suitability of the surgery, at 2-3 weeks interval and clinically responded patients underwent Radical Vulvectomy with or without Bilateral Groin Node Dissection.The data was analysed by SPSS data base. Results: The age of patients ranged between 30 and 80 years (mean age 55.8 years). of the104 patients, 74 patients were evaluable (BMMF: 14 & CMF: 60 ) and 30 patients were non compliant during the treatment protocol, and hence not included in the analysis. Majority of them belonged to Stage III/IVA locally advanced disease [50/74(67.56%)],[24/74(32.40%)]were in stageII.62 patients became operable afterpreoperative chemotherapy.Overall clinical response PR = 38. However, was found to be 71.42%(10/14) in BMMF regimen and 86.66% (52/60) in CMF regimen complete histological response was higher with patients received BMMF regimen. Conclusions: This study indicates that the pre-operative chemotherapy may help in downstaging of the advanced disease for operability with improved quality of life. Thus avoiding the need for extensive surgeries and major reconstructive procedures.