Contemporary management of primary carcinoma of the vulva.

Over the last 100 years the treatment of vulvar cancer has evolved dramatically. The adoption of radical surgical approaches brought high cure rates, but often with very significant physical and psychosexual morbidity. In the last 20 years, there has been an increasing emphasis on conservative and multimodality treatment. There is, however, good evidence that optimal outcomes are dependent on treatment in specialized multidisciplinary tertiary referral centers.