Background. An analysis of survival and complications related to the t
ype of radical vulvectomy operation performed is reported. Methods. Cl
inical records and pathology reports were reviewed for the time period
1975-1989. The operation, complications, and site of recurrent diseas
e were recorded. Results. The following types of surgical vulvectomies
were used: radical vulvectomy (28 cases), the technique with three se
parate incisions (42 cases), and en bloc radical vulvectomy (94 cases)
. There was no significant difference in survival between the patients
receiving en bloc radical vulvectomy or three separate incisions when
analyzed by stage of disease. The following numbers of local/regional
recurrences occurred among patients receiving the following treatment
regimens: radical vulvectomy, seven; the technique with three separat
e incisions, six; and en bloc radical vulvectomy, five. Three patients
treated by the separate-incision technique had a bridge recurrence. C
omplications were more frequent in those receiving the en bloc techniq
ue compared with those receiving the technique with three separate inc
isions: wound breakdown, 64% versus 38%, respectively (P = 0.005); wou
nd infection, 20% versus 12%, respectively (P = 0.4); wound cellulitis
, 21% versus 14%, respectively (P = 0.4); and lymphocyst formation, 28
% versus 14%, respectively (P = 0.08). Drain placement or prophylactic
antibiotics did not reduce wound infection or wound breakdown signifi
cantly. The most common sites of metastatic disease were the lungs and
subcutaneous tissues of the leg. Hypercalcemia occurred in four patie
nts, with the sites of metastatic disease being the subcutaneous tissu
e of the thigh (three patients) and pubic bone (one patient). Conclusi
ons. The technique with three separate incisions provides satisfactory
survival results with less morbidity compared with the en bloc techni
que of radical vulvectomy.