Hacker N F, Berek J S, Lagasse L D, Leuchter R S, Moore J G
Obstet Gynecol. 1983 Apr;61(4):408-12.
One hundred thirteen patients with invasive carcinoma of the vulva underwent radical vulvectomy and bilateral inguinal-femoral lymphadenectomy between 1957 and 1978. Eighteen had unilateral pelvic lymphadenectomy. Thirty-one patients (27.4%) had positive lymph nodes. The corrected actuarial five-year survival for patients with negative nodes was 96%, whereas it was 94% for patients with one positive node, 80% for those with two positive nodes, and 12% for those with three or more positive nodes. All patients with positive pelvic nodes or pelvic recurrence had three or more positive unilateral groin nodes, and all had palpably suspicious groin nodes preoperatively. Groin and systemic recurrences occurred in 2.9 and 3.8%, respectively, of patients with fewer than three positive unilateral inguinal-femoral nodes, as compared to 33 and 66%, respectively, of patients with three or more positive nodes. These data do not support routine pelvic lymphadenectomy in patients who have no clinically suspicious groin nodes and fewer than three positive nodes on histologic examination.
1957年至1978年间，113例外阴浸润癌患者接受了根治性外阴切除术及双侧腹股沟-股淋巴结清扫术。18例患者接受了单侧盆腔淋巴结清扫术。31例患者（27.4%）出现淋巴结阳性。淋巴结阴性患者的校正精算五年生存率为96%，而淋巴结阳性1个的患者为94%，阳性2个的患者为80%，阳性3个或更多的患者为12%。所有盆腔淋巴结阳性或盆腔复发的患者单侧腹股沟淋巴结阳性均达3个或更多，且术前腹股沟淋巴结均有明显可疑。单侧腹股沟-股淋巴结阳性少于3个的患者，腹股沟复发和全身复发的发生率分别为2.9%和3.8%，而阳性3个或更多的患者分别为33%和66%。这些数据不支持对临床无可疑腹股沟淋巴结且组织学检查阳性淋巴结少于3个的患者常规行盆腔淋巴结清扫术。
