Operative Therapie des Vulva- und Vaginalkarzinoms

Surgical treatment of cancer of the vulva and vagina is an important part of therapy. Complete removal of the tumour with an adequate safety margin is essential. Surgery can be used alone or in combination with lymph node staging and adjuvant therapy. However, it is associated with significant morbidity, which can be reduced by appropriate procedures. Complete resection of the tumour is possible for T1 and T2 vulvar cancer. The optimal safety margin is controversial, but some studies show that a margin of ≥ 3 mm may be sufficient. For small tumours less than 2 cm, wide excision can be performed without affecting the vulva. Larger tumours may require partial or total vulvectomy. The resection should provide a sufficient safety margin and preserve the function of the vulva. In some cases, reconstructive plastic surgery may be needed. However, there is limited data for vaginal cancer, so approaches for vulvar cancer are often used. Surgical treatment of vaginal cancer is challenging due to the anatomical location and is mainly recommended for small tumours. Depending on size and location, radical colpectomy may be required in addition to excision. Local recurrences may also require surgery.