Therapeutic implications of lymph nodal spread in lateral T1 and T2 XXXX .

@entity1 @entity957 @entity1544 @entity3 @entity717
From 1963 to 1993, 157 @entity1 with primary @entity957 were treated by radical surgery at the University of Kentucky Medical Center. There were 84 unilateral lesions confined to the labium majus or labium minus. Thirty-seven @entity1 had T1 lesions, median diameter 1.5 cm (range 0.5-2.0 cm), and 47 @entity1 had T2 lesions, median diameter 3.4 cm (range 2.2-9.0 cm). Radical vulvectomy with bilateral inguinal lymphadenectomy was performed in 56 @entity1 and radical hemivulvectomy with selective inguinal lymphadenectomy in 28 @entity1 . An average of 8 nodes was removed with superficial inguinal lymphadenectomy and 13 nodes with superficial and deep inguinal lymphadenectomy. Deep inguinal lymph node @entity3 occurred only in @entity1 with positive superficial inguinal lymph nodes. There were no contralateral inguinal lymph node @entity3 in any lateral T1 or T2 lesion. Following surgery, @entity1 were followed 1-15 years (mean 5.0 years) and none have been lost to follow-up. Nine @entity1 developed @entity717 , but no contralateral recurrences were noted. Seven of these @entity1 developed local recurrences to the ipsilateral vulvar skin and were cured by reexcision. Two @entity1 (2.4%), both of whom had positive ipsilateral superficial and deep inguinal lymph node @entity3 at the time of initial surgery, developed distant @entity3 and died of disease 10 and 11 months after treatment. These data suggest that deep inguinal lymph nodal @entity3 occurred only in @entity1 with superficial inguinal node involvement. Contralateral inguinal lymph nodal @entity3 are extremely rare in lateral T1 and T2 @entity957 . Radical hemivulvectomy is as effective as radical vulvectomy in the treatment of lateral T1 and T2 @entity1544 .
