Surgical Therapy of T1 and T2 Vulvar Carcinoma: Further Experience with Radical Wide Excision and Selective Inguinal Lymphadenectomy

摘要: Abstract Radical wide excision and selective inguinal node dissection provide a more conservative less morbid surgical option for women with vulvar carcinoma than en bloc radical vulvectomy bilateral inguinofemoral lymphadenectomy. We have expanded our initial experience this approach to 76 patients T1 (n = 33) T2 43) squamous carcinomas invasion >1 mm clinically negative groin nodes treated between 1978 1994. Lateral tumors 53) were frequent midline lesions 23). Tumors excised measured gross margin of 2 cm, was carried the deep perineal fascia. The mean largest tumor dimension 26 mm; depth 4.4 mm. Superficial lymphadenectomy, unilateral or depending on lesion location, performed. Perioperative complications occurred vulva in 8% cases 11%. Delayed complications, all related treatment, seen 29%. median follow-up interval 38 months. Seven (9%) had lymph metastases identified at their primary operation. Most received additional therapy; one has died disease. Nine (12%) developed recurrent disease vulva: controlled by resection. Four (5%) recurrence previously groin: three these are dead Actuarial 4-year survival is 81%. lymphadenectomy can be safely offered cancers. Patients known positive failure salvaged further therapy. Women unanticipated usually die These experiences similar those observed radically resected patients.