Between November 1978 and March 1990 319 patients with primary carcinoma of the vulva were treated at the Regional Department of Gynaecological Oncology at the Queen Elizabeth Hospital in Gateshead. Twenty-three of these had locally advanced disease which involved the anal and perianal skin, and were treated with radical ano-vulvectomy, bilateral inguinal-femoral lymphadenectomy, and in eight cases pelvic node dissection. Overall the 5-year survival rate was 62.1%. Survival in this group of patients with locally advanced disease was comparable to that reported in other series of similar patients treated with other modalities. Radical ano-vulvectomy has a valuable role to play in the treatment of this difficult problem.
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