[Prognostic factors of vulvar cancer]

While vulvar cancer is rare in Japan, the management of this disease has changed dramatically over the past 20 years. The radical vulvectomy that was previously believed to be the only effective treatment for vulvar cancer has now been replaced by more individualized treatments, from the standpoint of QOL. Because the lesion diameter and groin node status (laterality and number positive) are the most important prognostic factors of vulvar cancer, numerous refinements have been made in the management. The refinements include conservative surgery for patients with isolated lesions, omission of groin lymph node dissection in T 1 A tumors with stromal invasion <1 mm, and omission of contralateral groin lymph node dissection in T 1 tumor with negative ipsilateral node metastasis. In addition to these changes, elimination of groin dissection using sentinel lymph node procedure and preoperative chemoradiation for patients with advanced disease are currently under investigation. In this review, we discuss these issues along with the evidence upon which these therapies are based.