Pelvic lymphadenectomy in women with carcinoma of the clitoris.

Thirty-three women with carcinoma of the clitoris underwent surgical therapy, and 12% subsequently developed pelvic recurrence. However, none of the 18 patients without initial evidence of inguinal node metastases developed a pelvic recurrence. Of the 15 women with initial evidence of inguinal node metastases, 26.6% developed pelvic recurrence. It is, therefore, concluded that the addition of the routine use of pelvic lymphadenectomy to radical vulvectomy and bilateral inguinal lymphadenectomy in women with carcinoma of the clitoris is not warranted and that only those patients with histologically proven inguinal node metastases should undergo pelvic lymphadenectomy. If pelvic node metastases are documented, it is suggested that such patients receive postoperative pelvic irradiation.