Sugawa T, Umesaki N
Dept. of Obstetrics and Gynecology, Osaka City University Medical School.
Gan To Kagaku Ryoho. 1990 Sep;17(9):1864-70.
In the treatment of vulvar malignancy surgery, chemotherapy, irradiation therapy and so on can be used. Actually, it was rarely performed only by a single method. For treatment by the stage of cancer progression, the superficial cancer was treated by wide local resection for the patients except old women who were done simple vulvectomy. For the invasive cancer, stage 1 or 2, the pre-operative bleomycin (BLM) was administered to reduce the tumor mass, thereafter, radical vulvectomy with inguinal lymph node resection was performed. If inguinal lymph nodes metastasis was found, area of resection was extended to pelvic lymph nodes. Recently, micro-invasive carcinoma was defined that the foci was below 2 cm and interstitial invasion below 1 mm. In this condition, it was needless to remove the lymph nodes. For the stage of 3 or 4 which was inoperable, chemotherapy (mainly BLM) combined with irradiation therapy was done. In the cases of good general condition, it was chosen by super-radical vulvectomy.
在外阴恶性肿瘤的治疗中，可采用手术、化疗、放疗等方法。实际上，很少仅用单一方法进行治疗。根据癌症进展阶段进行治疗，对于表浅癌，除老年女性行单纯外阴切除术外，其他患者采用广泛局部切除。对于1期或2期浸润性癌，术前给予博来霉素（BLM）以缩小肿瘤体积，然后行根治性外阴切除术及腹股沟淋巴结切除术。若发现腹股沟淋巴结转移，则扩大切除范围至盆腔淋巴结。近来，微浸润癌被定义为病灶小于2 cm且间质浸润小于1 mm。在此情况下，无需切除淋巴结。对于无法手术的3期或4期患者，采用化疗（主要是BLM）联合放疗。对于一般状况良好的病例，则选择超根治性外阴切除术。
