Forty-two cases of vulvar cancer were reviewed with regard to clinical condition and therapeutic method, especially the efficacy of local administration of BRM. By histological examination, koilocytosis was found in 45%. Furthermore, there was 90% positive koilocytosis rate in immunohistological study using anti-human papilloma virus antibody and in situ hybridization method by HPV DNA probe (type 6, 11, 16, 18). The HPA was mostly type 16. Therefore, vulvar cancer was considered to occur in close relation with HPV type 16. Some 12% of vulvar cancer was complicated with other gynecologic cancer. In these cases, NK activity was low. Thus, cancer may be considered to occur in association with low immunological status. With regard to the therapeutic method, surgery and radiotherapy were usually used after chemotherapy in our institute. At stage 3-4, combination therapy using surgery and radiotherapy were found to be most effective. In regard to local immunotherapy using OK-432 and LAK cell and IL-2, local administration of OK-432 was effective. Therefore, surgery and radiotherapy with local immunotherapy after chemotherapy were considered to be the most effective therapeutic method for vulvar cancer.