Background. Current therapy of vulvar malignancies is reviewed with em
phasis on screening, etiology, diagnosis, staging, and treatment of pr
einvasive and invasive cancer. Methods, Screening procedures, etiologi
c possibilities, diagnostic techniques, staging implications, and trea
tment approaches are discussed in detail. Results. All malignancies of
the vulva should be detected at an early stage, when they are most am
enable to curative therapy. Regular examination of all women and incre
ased efforts to educate patients should in time reduce patient and phy
sician delay in diagnosis. The cause of the disease remains unclear, b
ecause the precursor state has not been defined accurately. The impetu
s to perform more conservative surgery has been accompanied by the rea
lization of the severe psychosexual sequelae associated with radical v
ulvectomy. High risk prognostic factors include number of positive gro
in lymph nodes and diameter of the primary lesion. Diameter of the lar
gest metastasis, intracapsular versus extracapsular nodal tumor locati
on, laterality of spread, and deep groin nodal spread may be predictor
s of survival. Conclusions. The overall incidence of vulvar malignanci
es will not be changed until the pathophysiology of the disease is bet
ter understood, Improved survival will depend on earlier and more accu
rate diagnosis and treatment, including use of radiation therapy.