RADIOTHERAPY FOR VULVAR CARCINOMA WITH POSITIVE INGUINAL NODES - ADJUNCTIVE TREATMENT

Between 1981 and 1988, 58 patients with vulvar carcinoma underwent rad ical vulvectomy and unilateral inguinal lymphadenectomy. Sixteen patie nts with inguinal node metastases received complementary radiotherapy as an alternative to pelvic node dissection. They were treated with Co -60 therapy for bilateral inguinal and pelvic lymph nodes. The overall five-year actuarial survival rate in patients without node involvemen t was 84%; in patients with positive inguinal nodes treated with the c ombined radiosurgical approach, it was 64%. Patients with 1 node invol ved had a 74% rate of estimated survival, and those with 2 or more met astatic nodes, considered to be at high risk, had an estimated surviva l rate of 49%. Only mild to moderate side effects related to the radia tion therapy were observed, and in no case was it necessary to interru pt the treatment. In terms of survival, the results obtained in the gr oup of patients with postoperative radiotherapy were better than those normally expected after pelvic lymphadenectomy, and as suggested in r ecent literature, point to the promising role of irradiation as adjuva nt management for vulvar cancer with node involvement.