RT Book, Section A1 Bristow, Robert E. A2 Bristow, Robert E. A2 Chi, Dennis S. SR Print(0) ID 1115054776 T1 Radical Vulvectomy: En Bloc Radical Vulvectomy, Separate Incision Radical Vulvectomy, Wide Radical Excision of the Vulva, and Inguinofemoral Lymphadenectomy T2 Radical and Reconstructive Gynecologic Cancer Surgery YR 2015 FD 2015 PB McGraw-Hill Education PP New York, NY SN 9780071808095 LK obgyn.mhmedical.com/content.aspx?aid=1115054776 RD 2024/03/29 AB Radical vulvectomy has 2 major variations: en bloc radical vulvectomy and bilateral inguinal lymphadenectomy and the technique with separate vulvar and groin incisions. Historically, all cases of vulvar cancer were treated by the classic en bloc radical vulvectomy popularized by Taussig and Way in the 1940s and 1960s.1,2,3 This procedure demonstrated superior outcomes compared with simple vulvectomy and, as a result, became the therapeutic approach for virtually all cancers of the vulva. Advances in the understanding of disease etiology, natural history, and prognostic factors precipitated changes in practice focusing more on individualization of care and paralleled the more contemporary realization that it is possible to adhere to the important principles of wide excision of the primary tumor and diagnostic/therapeutic removal of groin lymph nodes without performing radical vulvectomy with bilateral inguinal lymphadenectomy on all patients.4,5,6 In addition, recent advances in irradiation therapy combined with sensitizing chemotherapy have greatly reduced the requirement for radical vulvectomy as primary treatment of locally advanced vulvar cancer.7 Today, radical vulvectomy using separate groin incisions or radical wide excision is the preferred technique for most cases of locally advanced disease not amenable to treatment with chemoradiation, because this approach is associated with less risk of wound breakdown and overall morbidity.