Primary Chemoradiation VS. Neoadjuvant Chemotherapy Followed By Surgery As Treatment Strategy For LAVC

This study is comparing two treatment strategies for locally advanced vulvar cancer (cancer of the external female genitalia) where the tumor is near or involves sensitive structures. It compares definitive chemoradiation (radiation plus chemotherapy without surgery) versus chemotherapy first followed by surgery. **You may be eligible if...** - You are a woman aged 18 or older - You have confirmed squamous cell carcinoma of the vulva at a locally advanced stage (FIGO stage Ib or higher) - Your tumor is near or involves the urethra or anal sphincter, or you have groin lymph node spread that would require extensive surgery - Your blood counts and organ function are within acceptable ranges **You may NOT be eligible if...** - Your cancer has spread to the pelvic lymph nodes - Your tumor could be removed with a simple local excision without involving other organs - You have had prior radiation to the pelvis or groin that would prevent full-dose treatment - You have pre-existing nerve damage that prevents chemotherapy use - You have a psychiatric condition that prevents giving informed consent Talk to your doctor to see if this trial is right for you.