Cancer of the vulva

Abstract

Our study includes 50 patients operated on between on between 1970 - 1995 for vulvar carcinoma. The age of patients varied from 36 to 85 years old with a media of 59.4. The localisation of the lesions were: 42 (84%) on the major labia; 7 on the minor labia; 1 on the clitoris and 1 on the Bartholin's gland. Histopathologically there were 46 (92%) squamous carcinoma, 2 adenocarcinoma and 2 fibrosarcoma. The staging after FIGO classification: stage 1--7 patients (14%); II--22 (44%); III--20 (40%); IV--I (2%). Palpable lymphadenopathy in the inguino-femoral regions has been present to 24 (48%) patients, but with positive nodes (N+) only 16 (32%). Preoperative radiant therapy was applied to 21 patients (42%). All the patients were operated on: 1. total vulvectomy (vv) 15 cases (30%); 2. total vv + various lymphadenectomies 23 (46%); 3. partial vv 8 (16%); 4, different interventions 4 (8%). Iterative intervention for recurrencies: 9 cases (1 of them operated on by us 4 years anterior). Postoperative morbidity was present to 27 patients (52%): the main complication was the local infection of the wound +/- wound break-down; 5 of those patients presented also persistent lymphorrhagia. We don't noticed postoperative lymphedema of the inferior limb (limbs). Without postoperative lethality. Postoperative all the patients were submitted to a complimentary oncological treatment. The longest survival after the combined treatment was available specially for "N-"patients (but not exclusive). We verified 29 (58%) patients from the total of 50 (the rest being lost of evidence or having a short postoperative interval of time). The index of survival was: 1 year: 29 (100%); 3 years: 23 (79%); 5 years 16% (56%); and between 6 and 25 years 9 (31%). Conclusions: a) early diagnosis + therapy = good results; b) complex therapy is mandatory; c) optimal operation total vv + inguinal-femoral lymphadenectomy; d) the optimal prognosis is available for "N-" cases.