Girtanner R E, Kaufman R H
Baylor College of Medicine, Houston, Texas.
Curr Opin Obstet Gynecol. 1991 Feb;3(1):100-3.
Treatment of invasive vulvar malignancy has become more individualized during the past decade. In the past, radical vulvectomy with bilateral inguinofemoral lymphadenectomy was the standard therapy for invasive squamous cell carcinoma and melanoma of the vulva. This is no longer always the case. The treatment of stage I and stage II invasive squamous cell carcinoma of the vulva has become more individualized. Less radical surgery appears to produce the same results as ultraradical surgery. Wide local excision of early lesions associated with ipsilateral lymph node dissection appears to be adequate therapy in many cases. Likewise, treatment of early melanoma (0.75 mm in thickness) can be managed by wide local excision with or without groin dissection of the ipsilateral side. This more conservative approach has resulted in significantly fewer postoperative complications and has improved the self-image of many women undergoing treatment for vulvar malignancy.
在过去十年中，侵袭性外阴恶性肿瘤的治疗变得更加个体化。过去，根治性外阴切除术加双侧腹股沟股淋巴结清扫术是侵袭性外阴鳞状细胞癌和黑色素瘤的标准治疗方法。但现在情况已并非总是如此。外阴I期和II期侵袭性鳞状细胞癌的治疗变得更加个体化。不太激进的手术似乎能产生与超根治性手术相同的效果。在许多情况下，早期病变的广泛局部切除联合同侧淋巴结清扫似乎是足够的治疗方法。同样，早期黑色素瘤（厚度0.75毫米）的治疗可以通过广泛局部切除来进行，同侧腹股沟淋巴结清扫与否均可。这种更保守的方法显著减少了术后并发症，并改善了许多接受外阴恶性肿瘤治疗的女性的自我形象。
