Primary squamous cell cancer of the vulva: Radical versus modified radical vulvar surgery

Objective. To evaluate the results of surgical therapy and to specifically compare radical and modified radical vulvar surgery relative to survival, recurrence, metastasis, and complications. Methods. A retrospective review of 225 patients with primary squamous cell cancer of the vulva was performed. Clinical, pathologic, surgical, and follow-up data were collected from the patient records. All pathology slides were reviewed with a pathologist. Radical surgery included 134 patients treated by the Basset operation. Modified radical surgery accounted for 91 patients with vulvar excision alone (65) or with lymphadenectomy (26) via separate groin incisions. Results. The 5-year recurrence rate was 14%. The overall and disease-free survival rates at 5 years were 76.1 and 83.4%, respectively. There were no statistically significant differences between the two procedures regarding overall survival, disease-free survival, or the development of recurrence, even after adjusting for stage (P > 0.05). Patients undergoing radical vulvar surgery were more likely to develop surgical complications and sequelae than patients having modified radical surgery, even after adjusting for stage. Conclusions. Modified radical vulvar surgery is associated with decreased complications and 5-year overall and disease-free survival and recurrence rates similar to those of radical vulvar surgery, (C) 1998 Academic Press.