[Radical surgical treatment of epidermoid vulvar cancer. Results of ten years experience].

Objective: To review our series of radical vulvectomies and to compare it with results of conservatif treatment.

Material And Methods: We reviewed the 34 cases of vulvar squamous cell carcinoma treated in Hotel-Dieu de France, between January 1978 and December 1988. The treatment was a radical vulvectomy associated with either ipsilateral inguinofemoral lymphadenectomy (67.64%) or bilateral inguinofemoral and pelvic lymphadenectomy (32.26%).

Results: The age and the clinical presentation were consistent with the world literature as was the incidence of lymph node metastasis correlated with disease stage. The rate of local recurrence was consistent with the world literature (8.82% vs 12%) showing lower risk of urinary incontinence. Seroma and wound dehiscence correlated with stage were 20.6%m 26.5% and 11.8% for stages I, II and III respectively. The 5 year survival correlated with stage for these patients were: 87.5%, 63.1% and 42.8% for stages I, II and III respectively whereas the 5 year survival correlated with lymph nodes metastasis was 78% for node (-) and 42% for node (+).

Conclusion: Between 1978 and 1988,our therapy guideline for vulvar carcinoma was radical total vulvectomy. Modifications to this guideline were made specially in using a more conservative approach and radiotherapy when there was a risk of pelvic node involvement.