The surgical management of recurrent carcinoma of the vulva.

One hundred and two patients with recurrent vulvar cancer were treated with surgical re-excision. At follow-up 57 patients (56%) were free of disease and 45 were dead of disease. The cumulative 2-year and 5-year survivals were 74% and 61%, respectively. Fifty-seven patients had a recurrence within 2 years and 27 were free of disease, 30 patients relapsed between 2-10 years of whom 21 were free of disease, 15 patients relapsed after 10 years and 9 were free of disease. At the time of recurrence progression of metastatic disease to the groin lymph nodes was found in 30 cases, and all of these patients died of disease. Fifty-seven of 72 patients remained free of disease when the lymph nodes were not involved (P < .00001). Radical excision of localized recurrent vulvar cancer provides acceptable survival results when the regional lymph nodes are not involved.

Invasive cervical carcinoma in women up to age 30.

One hundred and seventy patients with invasive cervical cancer up to age 30 were treated and observed from 1970 to 1989. Twenty seven were in stage Ia, 81 in stage Ib, 38 in stage II, 20 in stage III and 4 in stage IV. The cases with poorly differentiated histological types predominated. Sixteen women were gravid at the moment of discovering the cervical carcinoma. Six patients were treated by conisation, total hysterectomy was used in 11 cases. Wertheim-Meigs' operation in 27 cases, Wertheim-Meigs' operation and postoperative radiation in 105 cases and intracavitary radium with external radiotherapy in 14 cases. Seven women were treated conservatively. Five, ten and fifteen year survival rates are 62%, 45% and 45%. Patients with stage I and without lymphogenic metastases have the highest survival rates. The young women with stage Ia and Ib have optimistic prognoses.