Invasive cancer of the vulva. Diagnosis, surgical management, and nursing care.

Postoperatively, vulvar cancer patients visit the physician's office frequently until the incision is healed completely. Follow-up visits are then continued biannually and eventually annually. Postoperative mortality is directly related to the extensiveness of the disease at the time of diagnosis. If the lymph nodes are negative at the time of surgery, the five-year survival rate approaches 90%; however, if lymph nodes are positive, the five-year survival rate drops to about 33%. Because most women diagnosed with invasive cancer of the vulva are elderly, many die of noncancer related diseases while tumor free. Recurrence, if it should occur, may be distant or local. Local recurrence usually occurs at the margins of the resection and distant recurrence in the deep pelvic nodes. The radical vulvectomy procedure with bilateral groin node dissection poses a significant challenge to the perioperative nursing team. This team plays an important role in helping the patient and her partner adjust to this extensive procedure.