Krupp P J, Bohm J W
Am J Obstet Gynecol. 1978 Apr 15;130(8):943-52. doi: 10.1016/0002-9378(78)90271-5.
Cancer of the vulva has responded to surgical therapy. "The problem now is to decide in what way the results may be improved." A clinical series of 195 patients who had extended vulvectomy and bilateral inguinal and pelvic lymphadenectomy were systematically examined for lymph gland metastases in the inguinal and pelvic regions. Forty-one patients had metastases in these lymph glands. Lesion site, lesion size, and patterns of metastases were delineated in these 41 patients. ;ariations in the pattern of central (clitoral) and lateral (labial) cancers were recorded. Risk factors of 20.5 and 4.6 per cent respectively, was calculated for omitting bilateral inguinal and pelvic lymphadenectomy. The latter figure indicated that one of 20 patients would have had residual disease if pelvic lymphadenectomy had been omitted. With out present inability to determine accurately lymph gland metastases by nonsurgical means, trends from this study indicate that optimum therapy requires addition of pelvic lymphadenectomy to extended vulvectomy and bilateral inguinal lymphadenectomy.
外阴癌对手术治疗有反应。“现在的问题是要确定如何才能改善治疗结果。”对195例行扩大外阴切除术及双侧腹股沟和盆腔淋巴结清扫术的患者进行了临床系列研究，系统检查腹股沟和盆腔区域的淋巴结转移情况。41例患者出现这些淋巴结转移。在这41例患者中明确了病变部位、病变大小和转移模式。记录了中央（阴蒂）癌和外侧（阴唇）癌转移模式的差异。计算出省略双侧腹股沟和盆腔淋巴结清扫术的风险分别为20.5%和4.6%。后一个数字表明，如果省略盆腔淋巴结清扫术，20例患者中会有1例残留疾病。由于目前我们无法通过非手术方法准确确定淋巴结转移情况，该研究的趋势表明，最佳治疗方案需要在扩大外阴切除术和双侧腹股沟淋巴结清扫术基础上增加盆腔淋巴结清扫术。
