Individualized treatment of stage I carcinoma of the vulva

A series of 117 patients with stage I squamous cell carcinoma of the vulva was followed for 3 to 21 years. Twenty recurrences (17.1%) were found, 12 in the vulva or vagina, 7 in the groin, and 1 in a patient who developed distant metastases. Invasion of tumor cells in lymph or blood vessels was found in operative specimens from 19 patients (16.2%), 8 of whom (42.1%) developed local recurrences of metastases. Of 76 patients who underwent lymphadenectomy, 7 had ipsilateral and 1 had bilateral metastases to the inguinal lymph nodes. Five-year crude survival rate for the whole series was 79%, but only 52% for the group of patients with vessel invasion. Treatment should in most cases be hemivulvectomy with ipsilateral inguinal lymphadenectomy.