PRIMARY SQUAMOUS-CELL CANCER OF THE VULVA - RADICAL VERSUS MODIFIED RADICAL VULVAR SURGERY

Objective. To evaluate the results of surgical therapy and to specific ally compare radical and modified radical vulvar surgery relative to s urvival, recurrence, metastasis, and complications. Methods. A retrosp ective review of 225 patients with primary squamous cell cancer of the vulva was performed. Clinical, pathologic, surgical, and follow-up da ta were collected from the patient records. All pathology slides were reviewed with a pathologist. Radical surgery included 134 patients tre ated by the Basset operation. Modified radical surgery accounted for 9 1 patients with vulvar excision alone (65) or with lymphadenectomy (26 ) via separate groin incisions. Results. The 5-year recurrence rate wa s 14%. The overall and disease-free survival rates at 5 years were 76. 1 and 83.4%, respectively. There were no statistically significant dif ferences between the two procedures regarding overall survival, diseas e-free survival, or the development of recurrence, even after adjustin g for stage (P > 0.05). Patients undergoing radical vulvar surgery wer e more likely to develop surgical complications and sequelae than pati ents having modified radical surgery, even after adjusting for stage. Conclusions. Modified radical vulvar surgery is associated with decrea sed complications and 5-year overall and disease-free survival and rec urrence rates similar to those of radical vulvar surgery, (C) 1998 Aca demic Press.