[Combination of radiotherapy and surgery for advanced cancer of the vulva]

From 1970-1985, seventy-six patients with advanced carcinoma of the vulva were treated. It accounted for 58.9% of all vulvar cancers seen in the same interval. According to the revised FIGO Staging System of Vulvar Cancer, 64 had Stage III, and 12 had Stage IV lesions. Fourty-eight patients had tumor extending to the distal urethra, vagina or anus. Fifty-one were treated by radiotherapy combined with radical vulvectomy and inguinal lymphadenectomy, 10 by surgery alone, 9 by radiotherapy alone and 6 by palliative radiotherapy. In 20 (55.6%) patients the tumor was reduced > or = 50% and in 4 (20%) patients the tumor completely disappeared after pre-operative radiation as shown in pathologic examination of the resected specimens. The 5-year survival rate was 46.9% for Stage III, 33.3% for Stage IV disease, with an over-all 5-year survival of 60.8% on the combined group. Surgery alone gave a 5-year survival rate of 30%. All the patients died of cancer within 5 years in the radiotherapy and palliative radiation groups. It is suggested that combined radiotherapy and surgery be preferred for advanced cancer of the vulva. Technique of encompassing the vulvar and inguinal areas needs to further studied and improved.