Positive lymph nodes in vulvar squamous carcinoma

Retrospective evaluation of 52 patients with positive lymph nodes at the time of curative primary surgery for invasive squamous carcinoma of the vulva reveals that those patients with three or less unilaterally positive groin nodes have an excellent prognosis. When more than three groin nodes are positive, or when bilateral groin nodes are present, there is a significant decrease in survival and a significant increase in positive pelvic node metastases. No cases of positive deep pelvic nodes were noted when the groin nodes were negative. Primary involvement of the clitoris followed a stepwise spread to the groin nodes and then to the deep pelvic nodes with no evidence of primary metastases to the deep pelvic nodes without groin node involvement.