RT Journal Article SR Electronic T1 Ultraradical surgery for advanced carcinoma of the vulva: an update JF International Journal of Gynecologic Cancer JO Int J Gynecol Cancer FD BMJ Publishing Group Ltd SP 369 OP 372 DO 10.1046/j.1525-1438.1993.03060369.x VO 3 IS 6 A1 M. S. Hoffman A1 D. Cavanagh A1 W. S. Roberts A1 J. V. Fiorica A1 M. A. Finan YR 1993 UL http://ijgc.bmj.com/content/3/6/369.abstract AB From July 1, 1955 to March 31, 1989 24 patients with locally advanced vulvar cancer underwent ultraradical resection. Three patients had received prior radiotherapy. Seventeen of the 24 patients underwent posterior exenteration, four underwent anterior exenteration, and the remaining three required a total pelvic exenteration. One patient died 3 months postoperatively of fulminating infection considered to be a complication of the operation. Three other patients experienced serious complications, including postoperative hemorrhage, severe urinary sepsis, and colostomy stoma necrosis. Eleven (46%) of the 24 patients have remained alive without evidence of recurrent cancer for at least 3 years. Of the 10 patients known to have died of recurrent cancer, nine had positive lymph nodes at the time of surgery. It may be reasonable to utilize ultraradical surgery in patients with clearly resectable lesions who have negative or perhaps 1 or 2 microscopically positive regional lymph nodes.