ULTRARADICAL SURGERY FOR ADVANCED-CARCINOMA OF THE VULVA - AN UPDATE

From July 1, 1955 to March 31, 1989 24 patients with locally advanced vulvar cancer underwent ultraradical resection. Three patients had rec eived prior radiotherapy. Seventeen of the 24 patients underwent poste rior exenteration, four underwent anterior exenteration, and the remai ning three required a total pelvic exenteration. One patient died 3 mo nths postoperatively of fulminating infection considered to be a compl ication of the operation. Three other patients experienced serious com plications, including postoperative hemorrhage, severe urinary sepsis, and colostomy stoma necrosis. Eleven (46%) of the 24 patients have re mained alive without evidence of recurrent cancer for at least 3 years . Of the 10 patients known to have died of recurrent cancer, nine had positive lymph nodes at the time of surgery. It may be reasonable to u tilize ultraradical surgery in patients with clearly resectable lesion s who have negative or perhaps 1 or 2 microscopically positive regiona l lymph nodes.