Squamous cell carcinoma of the vulva stage IA: Long-term results

Objective. The aim of this study was to evaluate the risk of metastases to lymph nodes and long-term results of radical and modified radical surgery i n patients with a T1 squamous cell carcinoma of the vulva and less than or equal to 1 mm of invasion. Methods. A retrospective review of 40 patients with TI squamous cell carcin oma of the vulva and less than or equal to 1 mm of invasion was performed. The clinical, pathologic, surgical, and follow-up data were abstracted from the patients' records. All slides mere reviewed by two pathologists accord ing to previously established guidelines. The overall mean follow-up was 7. 6 years. Results. Vulvar recurrence developed in 2 patients (5-year rate, 5.9%). The re were no groin recurrences among 10 patients undergoing groin lymphadenec tomy. One of the 30 patients (10-year rate, 6.7%) without groin dissection developed groin metastases at 7.5 years, subsequent to an invasive vulvar r ecurrence. The 5- and 10-year cause-specific survivals were 100 and 94.7%, respectively, Conclusion. T1 squamous cell carcinoma of the vulva with sl mm of invasion was associated with a low risk of vulvar recurrence and no groin node metas tases. A low risk of subsequent groin node metastasis exists in patients de veloping an invasive vulvar recurrence. Long-term follow-up of these patien ts is recommended. Lesser forms of vulvar excision, such as wide local exci sion, were equally effective as radical vulvectomy for the prevention of vu lvar recurrences. Patients treated by radical vulvar surgery experienced in creased postoperative complications compared with patients treated by less radical surgery. (C) 2000 Academic Press.