Arguments and algorithms to guide the clinical management of individual patients according to the local and regional cancer field model, applying ontogenetic anatomy for vulvar, vaginal, cervix, and endometrial carcinomas, are presented. From the locoregional extent of the malignant tumor diagnosed pre- and intraoperatively, its potential cancer field is deduced, which determines the proper surgical techniques to be performed. This approach does not only ensure the selection of optimal procedures for cancer field surgery but also indicates their limitations. If the ontogenetic stage-associated cancer field exceeds the tissues resectable at acceptable morbidity, alternative treatment modalities have to be selected. Clinical results obtained from large patient cohorts in the long term, considering survival and treatment-related morbidity, are reported as well.