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A report is given of 160 patients with vulval carcinoma who were managed by one Oncologist (J.M.M.) in a regional gynaecological oncology department. Prognosis was closely related to nodal mtastases which were in turn related to tumour size and degree of differentiation. These factors may be a guide to the need to carry out pelvic node dissection during radical surgical treatment. The place of radical surgery is emphasized and the need for postoperative staging suggested.