Prognostic significance of groin lymph node metastases in squamous carcinoma of the vulva.

A retrospective review of the clinical and histologic findings in 48 cases of stages I, II, and III (excluding T3) squamous carcinoma of the vulva with positive groin nodes reveals the prognostic significance of the size and number of the nodal metastases. Other factors such as the morphology of the lymph nodes and the histologic features of the primary neoplasm are not nearly as significant. Patients with only one or two small nodal metastases have an excellent outlook for survival providing that adequate margins can be obtained around the primary tumor and that thorough groin node dissections can be performed. These patients do not appear to need adjuvant radiation or pelvic node dissection. A further finding is that patients with unilateral labial carcinomas do not have metastases to the opposite groin in the absence of ipsilateral groin metastases, although six of 21 patients had metastases to both groins.