PELVIC EXENTERATION FOR PRIMARY AND RECURRENT VULVAR CANCER

Twenty-one patients who underwent pelvic exenteration for primary (n = 8) or recurrent (n = 13) vulvar malignancy at the M. D. Anderson Canc er Center between 1956 and 1989 were evaluated. A posterior exenterati on was performed in 12 patients, anterior exenteration was performed i n 6, and total exenteration was performed in 3. In patients with prima ry tumors, radical vulvectomy and inguinal lymphadenectomy were also p erformed. The median patient age was 57 years. The mean tumor diameter s were 5 cm (primary) and 4 cm (recurrent). Infections were the most f requent postoperative complications (n = 15), followed by pulmonary (n = 4) and cardiac problems (n = 3). There were no treatment-related de aths. Five patients required further surgery to correct late postopera tive sequelae. Four of eight patients experienced recurrence after tre atment of their primary tumor; the recurrences were local only (n = 1) , in the inguinal area (n = 2), or local and in the pelvis (n = 1). Ni ne of the 13 patients treated for recurrent tumors developed a second recurrence; the second recurrences were ah within the pelvis, although two also had a distant component. The 5-year survival rates were 70% for patients treated for primary disease and 38% for patients treated for recurrent disease. Pelvic exenteration is indicated for selected p atients with advanced vulvar malignancy. (C) 1995 Academic Press, Inc.