Body G, Lansac J
J Gynecol Obstet Biol Reprod (Paris). 1983;12(7):683-95.
The authors suggest a therapeutic scheme for carcinomata (intra-epithelial, micro-invasive and invasive) of the vulva after reviewing the literature and in the light of their own experience. It seems to them that treatment of these cancers can be carried out in the following way: Intra-epithelial cancers: partial vulvectomy for localised lesions or when treatment should be as conservative as possible. Total vulvectomy, or better still, superficial vulvectomy in other cases. Micro-invasive carcinomata: where the invasion is less than 2 mm: only total vulvectomy. Where the invasion is more than 2 mm: total vulvectomy with bilateral superficial lymphadenectomy. This is carried out as a complete lymphadenectomy when the lymph glands are found to be affected in the operating theatre. Invasive carcinomata: we exclude metastatic cancers where the local treatment is only carried out to give some palliation to the patient and sometimes can be combined with chemotherapy when that is possible. Patients that are operable: total vulvectomy with of course bilateral lymphadenectomy. This can be extended to iliac chains when Cloquet's gland is invaded. Radiotherapy after operation is to be discussed seeing that there are important sequelae from this. Lymph gland involvement can be unilateral in cases of N- stage I unilateral patients. Pelvic exenteration is only to be considered for young women who are in good general health and who have no pelvic metastases.
作者在回顾文献并结合自身经验后，提出了一种针对外阴癌（上皮内癌、微浸润癌和浸润癌）的治疗方案。在他们看来，这些癌症的治疗可按以下方式进行：上皮内癌：对于局限性病变或治疗应尽可能保守的情况，行部分外阴切除术。在其他情况下，行全外阴切除术，或者更好的是浅表外阴切除术。微浸润癌：浸润小于2mm时：仅行全外阴切除术。浸润大于2mm时：行全外阴切除术及双侧浅表淋巴结切除术。若术中发现淋巴结受累，则行完整的淋巴结切除术。浸润癌：我们排除仅为给患者提供某种姑息治疗而进行局部治疗且有时可在可能时联合化疗的转移性癌。可手术的患者：行全外阴切除术，当然还有双侧淋巴结切除术。当闭孔淋巴结受侵时，可扩展至髂血管旁淋巴结链。鉴于术后放疗有重要的后遗症，术后放疗需进行讨论。在N分期为I期的单侧患者中，淋巴结受累可能是单侧的。仅对于一般健康状况良好且无盆腔转移的年轻女性，才考虑行盆腔脏器切除术。
