[Electrosurgical radical operation of vulvar cancer with postoperative irradiation of the inguinal lymph nodes].

Clinical data on 607 patients with invasive squamous cell carcinoma of the vulva seen between 1952-1980 are reported. All of these patients were eligible for 5-year evaluation. The crude survival for these patients was 60.3%, and the cleaned 5-year survival for 530 patients was 69% (stage I [n = 158]: 87.3%, stage II [n = 118]: 83%, stage III [n = 182]: 66.5%, stage IV [n = 72]: 12.5%). A series of 141 patients with vulvar squamous cell carcinoma was analysed with regard to treatment of the inguinal lymph nodes. Crude survival for N0-N1 patients was 67%, for N2-N3 cases 43%. All patients were treated with radical vulvectomy using warm knife and open wound technique. Treatment of the regional lymph nodes was performed by irradiation alone. This simple surgical technique in combination with radiotherapy applied only to the inguinal lymph nodes gives an excellent result without complications associated with aggressive surgery. Lymph node dissection was performed in 5% of cases only, if lymph nodes were more than 2 cm. The combination therapy of electrosurgery and irradiation of the inguinal lymph nodes and renunciation of groin dissection gave rise to few complications only. This factor must be interpreted as very important, in particular since our 5-year survival rate compared with other reports was not low and the median age of our patients was very high.