Spinocellular carcinoma of the vulva. Critical review of the surgical case histories from 1967-1989]

A critical review of the surgical treatments performed during the years 1967 to 1989 in cases of squamous cell vulvar cancer at the 1st Department of Obstetrics and Gynecology of the University of Milan has been carried out. Two hundred and seventy cases of primary squamous cell vulvar carcinoma have been studied after a restaging according to recent FIGO recommendations. Depending on the type of surgical approach the early and late complications and the 5 year-cancer-related survival have been analyzed. The present investigation supports the importance of a complete and accurate surgical staging of vulvar carcinoma, particularly as far as it concerns the lymph nodes status. Thus, performing a node dissection in case of an invasive neoplasia is extremely important, not only for a precise staging but mainly for a prognosis formulation. In fact, 5 year cancer related survival dramatically falls from almost 90% to 25% in case of pelvic node metastasis.