摘要
目的：探讨手术方式对外阴恶性肿瘤预后的影响。方法：对５４ 例经手术治疗的外阴恶性肿瘤病人进行回顾性分析。外阴广泛切除加腹股沟淋巴结清除者３５ 例，外阴广泛切除或单纯外阴切除１９例。结果：总１ 、３ 、５ 、１０ 、１５ 年生存率分别为９８１ ％ 、７０６ ％ 、４７６ ％ 、３８９ ％ 、３３３ ％ ；外阴鳞癌Ⅱ期１ 、３ 、５ 、１０ 年生存率分别为１０００ ％ 、６８４ ％ 、６６７ ％ 、７５ ．０ ％ ， Ⅲ期分别为１０００ ％ 、７２７ ％ 、４５５ ％ 、２００ ％ ；腹股沟淋巴结阳性者５ 年生存率为１５４ ％ ，而腹股沟淋巴结阴性者５ 年生存率为９０９ ％ 。结论：临床分期及腹股沟淋巴结转移情况对预后影响明显，临床分期不同手术方式的选择亦有差别，Ⅱ期病人应选择创伤小并发症少的手术方式，Ⅲ期病人则以外阴广泛切除加腹股沟淋巴结清除术最适宜。
Objective:To approach operative modalities how to influence the prognosis on vulval malignancies.Methods:54 patinents with vulval malignancies treated in our hospital by operation were analysed retrospectively.35 received radical vulval resection combined with bi inguinal lymphnode dissection,19 were given radical vulva resection or local vulva resection.Results:The survival rate of 1,3,5,10,15 years was 98 1%,70 6%,47 6%,38 9%, 33 3% ,respectively;The survival rate of 1,3,5,10 years was 100 0%,68 4%,66 7%,75 0%,for stage Ⅱ patients,respectively and 100 0%,72 7%,45 5%,20 0% for stage Ⅲ patients;The survival rate of 5 years of patients with inguinal lymphnode positive and negative was 15 4% versus 90 9%.Conclusions:Clinical staging and metastasis of inguinal lymphnode were important factors influencing the prognosis of the disease. The operative modalities should be different for different stages, the patients of stage Ⅱ should be given the less injured and fewer complications operative modes,radical vulva resection and bi inguinal lymphnode dissection was the best choice for stage Ⅲ patients.
