Radical Surgery for T1 and T2 Squamous Cell Carcinoma of the Vulva Through Separate Incisions
Apichart Khobjai, MD*, Jatupol Srisomboon MD*, Kittipat Charoenkwan MD*, Chailert Phongnarisorn MD*, Prapaporn Suprasert MD*, Sitthicha Siriaree MD*, Chalong Cheewakriangkrai MD*, Charuwan Tantipalakorn MD*, Chumnan Kietpeerakool MD*.
Affiliation : * Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University, Chiang Mai
Objectives : The aim of the study was to retrospectively evaluate treatment results in patients with T1 and T2
vulvar carcinoma.
Materials and Methods : The medical records of 46 patients with T1 and T2 SCC of the vulva undergoing radical
excision of the tumor and groin node dissection at Chiang Mai University Hospital between January 1998
and December 2004 were reviewed. The tumor size, histologic grade, nodal status, lymph-vascular space
invasion, lesion location, surgical marginal status, complications, recurrence and survival were analyzed.
Results : Mean age of the 46 patients (T1 = 15, T2 = 31) was 59 years with a range of 34–84 years. The
incidence of lymph node metastases for T1 lesions was 13% compared to 35% for T2 lesions. Twenty nine
patients (63%) experienced surgical complications, the most common one was lymphedema (16) while wound
breakdown was noted in only 1 patient. With a median follow–up of 15 months, 14 patients (30%) developed
recurrence, 3 (20%) and 11 (35%) in patients with T1 and T2 lesions respectively. The overall 5–year disease-
free survival and 5-year survival were 37% and 40%, respectively. The 5–year survival of patients with T1
lesion was significantly higher than that of patients with T2 lesion (64% vs 31%, P = 0.04). Patients with
negative nodes had significantly better survival than those with positive nodes (56% vs 18%, P = 0.02). In
multivariable analysis, only the status of groin node remained as independent prognostic factors for survival.
Conclusion : Radical excision and groin node dissection through separate incision for T1 and T2 squamous
cell carcinoma of the vulva in this study has a less favorable survival outcome compared with the literature.
Keywords : Vulvar carcinoma, Radical surgery, Separate incision
