Univariate and multivariate analyses of 5-year survival, recurrence, and inguinal node metastases in stage I and II vulvar carcinoma.

Ninety-seven patients with FIGO stage I and II vulvar carcinoma were analyzed for 5-year survival, inguinal node metastases (N = 61), and recurrence. Factors analyzed included stage, tumor grade, depth of invasion, presence or absence of tumor cell confluence, presence or absence of lymphatic/vascular space invasion, lesion size, and lymph node metastases. It was concluded that conservative surgery in patients otherwise suitable for surgery should consist of a wide, local excision of the vulvar lesion in conjunction with ipsilateral inguinal node resection if the tumor measured less than or equal to 1 cm in diameter and had a depth of invasion of less than or equal to 1 mm. All other stage I or II patients require radical vulvectomy and bilateral inguinal lymphadenectomy.