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Radical Vulvectomy for Invasive Squamous Cell Carcinoma of the Vulva

From the Department of Obstetrics and Gynecology, Ohio State University, College of Medicine, Columbus, Oh 43210.

Abstract

Ninety patients with invasive squamous cell carcinoma of the cervix were seen between 1940–1971. The most common local characteristic associated with vulvar carcinoma was leukoplakia in 21 patients. Despite a significant delay before therapy, two-thirds of the patients had FIGO clinical Stages I and II. Adequate surgical therapy, as defined, in 60 patients resulted in a 66.6% 5-year survival rate; inadequate therapy yielded a 26.6% 5-year survival rate. The absolute 5-year survival rate was 52.5%. Radical excision of the primary lesion must be reemphasized to prevent deaths in the absence of negative lymphadenectomy. Although inguinal or Cloquent's nodes would have been useful indicators in assessing pelvic nodes, the procedure was not employed on a routine selective basis. The size and histology of the primary lesion were related to the incidence of lymph node metastases. Clinical appraisal of inguinal nodes appears to be useful in staging vulvar carcinomas.