Twenty two patients with primary invasive carcinoma of the vulva were treated at Seoul National University Hospital from. 1980 to 1991 and their clinicopathological profiles were analyzed retrospectively. The median age of the patients was 50
years(32
81 years). The most frequent presenting symptom was a palpable lump or mass observed in 14 patients(63.6%), followed by pruritis in 12 patients(54.5%) and pain in 10 patients(45.5%). As a standard therapy, radical vulvectomy with bilateral
inguinofemoral lymphadenectomy was perfromed in 17 patients and simple vulvectomy was done in one patient. Eight patients of them had reconstructive surgery with local cutaneous(5 patients) or myocutaneous(3 patients) flaps. Chemotherapy or
radiotherapy
was performed in 3 patients and one patient rejected the treatment. Nineteen patients(86.4%) had squamous ell carcinoma, 2(9.1%) had adenocarcinoma of the Bartholins gland, and one(4.5%) had melanoma. Of 18 surgically treated patients, 5 were
stage
I
(27.8%), 7 were stage II(38.8%), 2 were stageⅢ(11.1%), 3 were stage Ⅳa(16.7%) according to FIGO surgical staging, and one had melanoma of Clark's level Ⅳ. Two(11.1%) of them had lymph node metastasis. There was no case of primary mortality but
morbidity was observed in 16 patients(88.9%). The 5 year survival rate 18 surgically treated patients was 65.3%(median follow-up 47 months). This experience suggests that more conservative surgery should be considered in the management of
selected
patients with primary invasive vulvar cancer.
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