Conservative surgical management of superficially invasive stage I vulvar carcinoma

Fifty patients with stage I squamous cell carcinoma of the vulva were treated by means of wide local excision and either unilateral or bilateral superficial inguinal lymphadenectomy. Depth of invasion per se was not an exclusionary criterion; however, 36 of 37 patients for whom depth of invasion could be assessed had tumors invasive to a maximum depth of 5 mm. Factors investigated included recurrences and survival in addition to the early and delayed morbidity associated with this operative approach. Recurrent intraepithelial or minimally invasive cancer was documented in six patients, five of whom were treated successfully by a subsequent wide local excision following initial surgery. Only one patient died of recurrent carcinoma 16 months following surgery. The morbidity with this operation was appreciably less than that generally reported with more extensive operations commonly employed in the management of vulvar cancer and is recommended for management of patients with early invasive disease.