[Results of different forms of therapy in vulvar neoplasms]

In this retrospective study 216 patients who have been treated for malignant vulva neoplasms between the years 1968 and 1987 at the Department of Obstetrics and Gynaecology of the University of Kiel are reviewed. Staging according to the Figo-Classification revealed stage I in 13.0%, stage II in 63.0%, stage III in 20.2% and stage IV in 3.8%. During these years treatments applied to these elderly patients often with multimorbidity, aside from the combined treatment according to Berven (27.9%) was in the majority of cases a modified radical treatment (34.1%). The modified radical treatment consisted primarily of simple vulvectomy and tumor excision followed by radiation therapy. Primary radiation therapy was performed in the cases where either local or general noperabilityx was established (29.3%). The 5-years-survival rate of the investigated patients was 31.7%, whereby radical vulvectomy which was performed in a few cases offered the best results. A comparison between the modified radical therapy and the combined therapy according to Berven resulted in equally divided staging groups similar 5-years-survival rates of 39% and 38% respectively. However, the modified radical therapy group demonstrated better results in the first 4 years. Within the modified radical treatment group patients undergoing simple vulvectomy revealed a better survival rate after 3 years than did patients undergoing tumor excision followed by radiation therapy. The long term results of these two modes of modified treatment equal out over 10 years. Therefore, from the results presented we recommend in the case of elderly patients with multimorbidity the modified radical therapy via simple vulvectomy.