Radical vulvectomy combined with elective node irradiation for TxN0 squamous carcinoma of the vulva

The conventional treatment for squamous carcinoma of the vulva with negative nodes (N0) is radical vulvectomy and bilateral node dissections. Approximately 20–30% of N0 patients will have involved nodes in the surgical specimen. The morbidity/mortality added by the node dissections may be considerable, especially for the two of three patients who are not aided by the procedure. Radical vulvectomy followed by elective node irradiation of 4500 R in 5 weeks has been used in six patients. The treatment combination is well tolerated with no node failures, no radiation complications, no delay in healing of the surgical site, and an average hospitalization of 13 days.