Infiltrative carcinoma of the vulva: results of surgical treatment.

During a 40 year period 374 patients with infiltrative carcinoma of the vulva were evaluated. Some form of radical surgery was the treatment chosen for 278 patients. The absolute 5 year survival rates for all clinical stages treated with some form of radical surgery was 66.8 per cent with a corrected rate of 73.9 per cent. The corrected 5 year survival rate for patients treated with radical vulvectomy and groin lymphadenectomy approximated 80 per cent and if the regional lymph nodes were negative, it approximated 93 per cent. The size of the primary lesion and the incidence of regional lymph node metastases seemed directly related. Lymph node involvement itself significantly reduced the chance for survival. Furthermore, the inaccuracy of preoperative evaluation of the groin lymph nodes approximated 25 per cent. The assumption that a lesion is "early" does not justify less than radical surgery. Conversely, the "advanced" lesion when geographically localized can be treated quite satisfactorily with pelvic exenteration. The treatment of choice is discussed.