Treatment of Cancer of the Vulva

The results of various forms of primary treatment of cancer of the vulva during the decade 1958‐1968 in the Radium Centre, Århus Municipal Hospital, University of Århus, are submitted. The series consists of 67 patients classified by the T‐N‐M system (U.I.C.C. 1967). Comparison of 29 patients treated by vulvectomy and node dissection with 26 patients treated by less extensive surgery without node dissection showed a 19% higher corrected 4 year survival and a 14% lower nodal recurrence rate in the former group although according to the T‐N‐M classification it must be presumed to have contained rather more advanced cancers. There was quite a marked difference between the clinical assessment of the regional lymph nodes and the histological findings at dissection. This applied to the histologically positive as well as negative lymph nodes. A review of the literature shows that the present results are in keeping with previous publications which have shown that the treatment of choice in cancer of the vulva is still total vulvectomy with routine dissection of the superficial and deep inguinal lymph nodes, supplemented by dissection of the iliac lymph nodes, if histological examination during the operation shows positive lymph nodes in the inguinal region.