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[Retrospective assessment of the feasibility of conservative surgery in the vulvar squamous cell carcinoma].

OBJECTIVES
Radical vulvar surgery is associated with significant morbidity.


DESIGN
The aim of the study was to assess retrospectively the feasibility of less extensive surgery in vulvar cancer patients operated in our institution with radical intent. The feasibility of less extensive surgical procedures was investigated, based on the retrospective analysis of preoperative assessment of tumour location and extent in a group of 162 patients.


RESULTS
In the next step, the pathology reports of actually performed extensive operations were carefully reviewed in a search of microscopic evidence of tumour outside the limits of proposed conservative procedures. Conservative surgery was regarded technically possible in 127 patients (85.8%). Macro- or microscopic multifocality was detected in 22 patients (14.9%), of whom in 15 cases conservative surgery was regarded possible on the basis of clinical assessment. However, only in 11 cases tumour was found outside the limits of planned excision, in 9 of those cases--due to multifocal lesions.


CONCLUSIONS
Less extensive surgery is technically feasible in a vast majority of vulvar cancer patients, however the selection for conservative procedures based only on clinical assessment of tumour extent is not sensitive enough to assure radical treatment in all patients and better methods of preoperative evaluation, such as vulvoscopy or random vulvar biopsies need to be investigated before the decision on routine use of conservative surgery is made.