role of conservative surgery in squamous cell carcinoma of the vulvar

Vulvar cancer is a rare gynecological malignancy since it represents 4% of all cancers of the female genital tract. The most common histological type is squamous cell carcinoma (90%). This type can be classified into two clinicopathological subtypes according to the etiology. The first subtype is associated with persistent human papillomavirus infection and is usually diagnosed in younger women. The second subtype is associated with lichen sclerosus condition, and in most cases is diagnosed in postmenopausal women...

In recent years, vulvar cancer management has been revolutionised with a more conservative approach being recommended for the primary lesion, and a more rational approach to the management of the lymph nodes. Treatment has become individualised with consideration being given independently to the optimal approach for the primary lesion and regional lymph nodes. The primary vulvar lesion can be effectively treated by radical local excision, thereby sparing the psychosexual consequences of radical vulvectomy in most patients...

PURPOSE: Controversies exist regarding the use of radiation therapy in the treatment of vulvar carcinoma. A retrospective review was performed to evaluate our institution's experience with surgery and radiation for this disease. METHODS AND MATERIALS: The medical records of 47 patients treated for squamous cell carcinoma of the vulva at our institution (1974-1992) were reviewed for TNM stage (AJCC criteria), treatment modality, and associated 5-year local control and survival based on Kaplan-Meier analysis...