Vulvar cancer surgery — Surgery as First-Line Treatment for Vulvar Cancer
For the majority of invasive vulvar cancers, surgery is the primary treatment modality. The goal is complete excision of the primary tumour with clear margins (ideally 8 mm or more of histological clearance), alongside management of the regional inguinal (groin) lymph nodes — the first site of metastatic spread.
On this page
- Surgery as First-Line Treatment for Vulvar Cancer
- Wide Local Excision
- Inguinal Lymph Node Management
- Post-Operative Recovery
Historical radical vulvectomy — removal of the entire vulva through a single butterfly-shaped incision — has been replaced by individualised conservative surgery that removes only the affected area, with significant improvements in quality of life and wound complication rates.
Wide Local Excision
Wide local excision (WLE) with adequate surgical margins is the current standard for most unifocal vulvar cancers. The procedure removes the primary lesion with a margin of normal tissue and can usually be performed under spinal or general anaesthesia as a day procedure or with a short hospital stay. Complex cases involving the clitoris, urethra, or anus may require reconstruction with local tissue flaps.
Inguinal Lymph Node Management
The groin lymph nodes are the primary drainage pathway from the vulva. Lymph node status is the single strongest predictor of prognosis in vulvar cancer. There are two surgical approaches:
- Inguinofemoral lymphadenectomy — systematic removal of all superficial and deep inguinal lymph nodes. Provides definitive staging but carries significant morbidity: wound breakdown, lymphoedema of the legs (affecting 25–30% of patients), and lymphocyst formation.
- Sentinel lymph node biopsy (SLNB) — a radiotracer and/or blue dye is injected near the tumour before surgery; the sentinel node is identified and removed. If the sentinel node is negative for metastasis, the remaining groin nodes are not removed, dramatically reducing lymphoedema and morbidity. SLNB is validated for unifocal vulvar SCC ≤4 cm without clinical groin node involvement.
The GROINSS-V trial established SLNB as a safe and oncologically sound alternative to full groin dissection in appropriately selected patients, with a 3-year recurrence-free survival of 97% in sentinel-node-negative women.
Post-Operative Recovery
Recovery from vulvar surgery depends on the extent of excision. Hospital stay is typically 3–7 days. Wound healing in the perineal area can be slower due to the moist environment. Patients are advised to avoid strenuous activity for 4–6 weeks and are reviewed regularly.
Adjuvant radiotherapy to the groin and pelvis is recommended when lymph nodes are found to be positive. In cases of close surgical margins at the primary site, localised vulvar radiotherapy may also be given.
For a specialist consultation about vulvar cancer surgery in Ahmedabad, contact Dr. Nishtha Tripathi Patel at Sterling Hospitals, KD Hospital, or Welcare Speciality Hospital. Tel: +91 76988 00333.
Further Reading & Sources
Related Pages on This Site
Consultation and Next Steps
For an individualised consultation on vulvar cancer surgery, share your reports on WhatsApp at +91 76988 00333. Dr. Nishtha Tripathi Patel provides a detailed assessment within 24-48 hours and arranges in-person consultation at Sterling Hospitals, KD Hospital, or Welcare Speciality Hospital in Ahmedabad based on your location and treatment requirements.
Bring the following to your first consultation: imaging studies (ultrasound, CT or MRI on CD), histopathology and biopsy reports, tumour marker results (CA-125, HE4, CEA where relevant), a list of current medications, and any prior treatment summaries. For patients travelling from outside Ahmedabad, scheduling can be arranged to complete consultation and any pre-op work-up in the fewest possible visits.
If you are exploring second-opinion options, see our second-opinion service page. Independent review of diagnosis, staging, and proposed treatment plans is provided at no cost via WhatsApp report review. You do not need to switch hospitals to obtain a second opinion.
For broader information about vulvar cancer surgery and related conditions, also see our complete ovarian cancer guide, HIPEC India guide, cervical cancer guide and robotic surgery guide.