Carcinoma of the vulva: analysis of treatment and survival.

The treatment of 224 patients with invasive squamous cell carcinoma of the vulva over a 20-year interval at the Mayo Clinic resulted in an overall survival rate of 75%, compared with 89% for age-matched controls. For patients with stage I disease, 5-year survival was 90%; for those with stages II, III, and IV, it was 81, 68, and 20%, respectively. A precipitous decline in survival rates was noted when metastases to regional nodes were encountered, when lesion size was more than 3 cm, and when histologic dedifferentiation exceeded grade 2. Incorrect clinical staging efforts were observed in 25% of the cases, so the necessity for surgical staging was apparent.