[Surgical treatment of locally advanced vulvar cancer: report on two cases]

The aim of the study was to define the notion of locally advanced vulvar cancer (LAVC) and approaches to treatment by presenting clinical cases encountered by the authors.

The clinical cases described present different views on therapeutic approaches to cases with LAVC. Apart from cases of primary advanced vulvar cancer, there exist cases, in which primary treatment was applied. In such cases, however, involvement of adjacent structures was a result from recurrence of the disease. LAVC implies that the primary or recurrent tumour cannot be treated solely by radical removal of the vulva. Modem treatment of LAVC include ultraradical surgery, radiotherapy, chemoradiotherapy, or a combination of these methods. Studies have confirmed the hypothesis that megovoltage radiotherapy can yield a significant regression of LAVC that makes it possible to apply more sparing surgical resections and preserve the functions of adjacent organs, thus improving life quality.

Surgical treatment of LAVC without preoperative chemoradiotherapy is recommendable only in cases of resectable tumours, possibly with non-metastatic and primarily resectable regional lymph nodes.