Squamous cell carcinoma of the vulva stage IA: Long-term results

Objective. The aim of this study was to evaluate the risk of metastases to lymph nodes and long-term results of radical and modified radical surgery in patients with a T1 squamous cell carcinoma of the vulva and ≤1 mm of invasion. Methods. A retrospective review of 40 patients with T1 squamous cell carcinoma of the vulva and ≤1 mm of invasion was performed. The clinical, pathologic, surgical, and follow-up data were abstracted from the patients' records. All slides were reviewed by two pathologists according to previously established guidelines. The overall mean follow-up was 7.6 years. Results. Vulvar recurrence developed in 2 patients (5-year rate, 5.9%). There were no groin recurrences among 10 patients undergoing groin lymphadenectomy. One of the 30 patients (10-year rate, 6.7%) without groin dissection developed groin metastases at 7.5 years, subsequent to an invasive vulvar recurrence. The 5- and 10-year cause-specific survivals were 100 and 94.7%, respectively. Conclusion. T1 squamous cell carcinoma of the vulva with ≤1 mm of invasion was associated with a low risk of vulvar recurrence and no groin node metastases. A low risk of subsequent groin node metastasis exists in patients developing an invasive vulvar recurrence. Long-term follow-up of these patients is recommended. Lesser forms of vulvar excision, such as wide local excision, were equally effective as radical vulvectomy for the prevention of vulvar recurrences. Patients treated by radical vulvar surgery experienced increased postoperative complications compared with patients treated by less radical surgery.