Indications and results of postoperative radiotherapy in case of vulvar carcinoma

Between 1968 and 1979, 132 patients with squamous cell carcinomas of the vulva were submitted to a more or less radical operation. Then they were irradiated at the Radiologic Center of the GHS Essen. All patients received irradiations of the vulvar region with high energy electrons combined with photons (n=78) as well as photons or electrons alone (n=15 and 39, respectively). The dose was generally 40 to 60 Gy. 81 patients (61.4%) were additionally irradiated in the inguinal region. The overall three-year and five-year survival rate is 48.5 and 34.1%, respectively. The median survival time is 31.5 months. Contrary to expectation there were no significantly different recurrence rates after radical vulvectomy and large excision combined with postoperative irradiation. This is attributed to the favorable effect of radiotherapy. A graduated conception has been elaborated based on the results of our retrospective analysis and the communications of literature. Radical vulvectomy and inguinal lymphadenectomy is the therapy of choice. Radiotherapy in the vulvar region should be applied if radical surgery seems problematic or is not possible. Irradiation of lymph node regions is indicated if they are involved or if a resection is not possible. (orig.)