The modified radical vulvectomy with groin dissection: an eight-year experience

Area of Science:

• Gynecologic Oncology
• Surgical Oncology

Background:

• Squamous cell carcinoma of the vulva is a significant gynecologic malignancy.
• Treatment of vulvar cancer requires careful consideration of surgical margins and lymph node status.

Purpose of the Study:

• To evaluate the efficacy and safety of modified radical vulvectomy and bilateral groin dissection for vulvar squamous cell carcinoma.
• To assess recurrence rates and outcomes based on surgical technique and disease stage.

Main Methods:

• Retrospective analysis of 51 patients diagnosed with squamous cell carcinoma of the vulva (depth > 1 mm) between 1978 and 1986.
• Surgical treatment included complete radical vulvectomy with bilateral inguinofemoral lymphadenectomies (n=14) or individualized excision patterns with bilateral inguinofemoral lymphadenectomies (n=28).
• Five advanced lesions were treated with combined radiation and surgery; four patients had recurrent disease.

Main Results:

• None of the 28 patients treated with individualized vulvectomy and lymphadenectomy experienced recurrence.
• Five patients had positive lymph nodes; eight died of unrelated causes.
• Lesions were Stage I/II in 25 cases and Stage III in three cases.

Conclusions:

• Modified radical vulvectomy combined with bilateral groin dissection is a safe and effective surgical strategy for most patients with Stage I and II vulvar squamous cell carcinoma.
• This approach may also be considered for select patients with Stage III lesions.