Diagnosis and management of XXXX .

@entity1 @entity66 @entity5 @entity189 @entity260 @entity1442 @entity6068
With the steady increase in life expectancy, invasive @entity5 is now becoming more prominent among gynecologic @entity5 . Early, careful examinations and informed @entity1 can aid in early diagnosis. @entity189 in situ, verified by biopsy, is best treated with wide local excision. Invasive @entity189 should be treated with radical vulvectomy and bilateral groin node dissection. The major source of morbidity is wound breakdown. The use of modified incision techniques and sartorius muscle transplantation have significantly decreased these @entity260 . The clinical staging system for @entity189 is approved by the International Federation of Gynecology and Obstetrics (FIGO). The disease usually spreads systematically from the vulva to superficial groin nodes, to deep groin nodes, and then to pelvic nodes. Survival rates of 84% for stage I disease can be achieved. Evidence of positive groin nodes indicates a poor prognosis. However, even @entity1 with @entity1442 can be surgically cured by radical surgery. Five of ten @entity1 (50%) with stage IV disease were @entity66 at five years with exenterative surgery. Any @entity1 who is a reasonable medical risk, with a @entity6068 that is resectable, should be treated surgically. Otherwise, the @entity1 not only die, but they die in abject misery.
