Surgery is the mainstay of the treatment of vulvar cancer. Radical vulvectomy together with some form of lymphadenectomy is the usual treatment today, but the desire to minimize morbidity have led to a selective decrease in the extent of the surgery in recent years. We recommended retroperitoneal pelvic lymphadenectomy be used only if the inguinal nodes were positive. The approach has become widely accepted. Improvements in perioperative care and anesthetic techniques have allowed the surgical approach to be used in most patients, even in older women seen so commonly with this cancer.
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