112 Surgical treatment remains the cornerstone for managing vulvar cancer, but complications continue to present significant challenges for patients and healthcare systems. A comprehensive review has shed light on the persistent prevalence of post-surgical issues and highlighted areas for potential improvement in outcomes. The findings were published in the journal Gynecologic Oncology. The primary treatment for vulvar cancer typically involves surgery on the vulva combined with lymphadenectomy in the groin region. This is often supplemented with radiotherapy or chemotherapy in advanced cases. While these procedures aim to enhance survival rates, they frequently result in severe physical and psychological consequences. The review examined complications related to surgical treatment, particularly those arising from inguino-femoral lymphadenectomy and vulvar surgery. Lymphadenectomy, a procedure performed to remove lymph nodes in the groin, is crucial for determining the spread of cancer. But it is also associated with a high rate of complications, including lymphoedema, lymphocele, wound infection, and breakdown. These issues affect a substantial portion of patients, with lymphoedema rates ranging from 14% to nearly 50%, depending on individual risk factors such as obesity and radiation exposure. Newer techniques, such as sentinel lymph node biopsy (SLNB), have been identified as promising alternatives. SLNB involves targeting only the initial lymph node affected by cancer, thereby sparing others from unnecessary removal. Studies demonstrate that SLNB significantly reduces the risk of lymphoedema compared to traditional lymphadenectomy. Surgery on the vulva itself can lead to wound infections, breakdowns, and psychological challenges. These complications are influenced by factors such as obesity, diabetes, and the location of the tumour. Additionally, the impact of surgery on body image and sexual function often leads to long-term distress for many patients. Advances in surgical techniques, including the use of skin flaps and grafts, have helped mitigate some risks by improving wound closure and reducing tension. However, addressing psychological and sexual health complications remains a critical unmet need in the care of vulvar cancer patients. The review emphasises the need for continued innovation in surgical techniques and better preoperative counselling to manage expectations and prepare patients for recovery. Preventative measures, such as saphenous vein sparing and the judicious use of anticoagulation therapy, have shown potential in reducing specific complications like lymphoedema and lymphocele. Despite progress, complications from vulvar cancer surgery remain a major concern. The review calls for more robust, multicentre studies to refine treatment protocols and develop standardised measures for evaluating surgical outcomes. These steps are essential to improving quality of life for patients undergoing this challenging treatment.