Vulvar cancer: epidemiology, clinical presentation, and management options

Int J Womens Health. 2015 Mar 20;7:305-13. doi: 10.2147/IJWH.S68979. eCollection 2015.

Abstract

Epidemiology: Vulvar cancer can be classified into two groups according to predisposing factors: the first type correlates with a HPV infection and occurs mostly in younger patients. The second group is not HPV associated and occurs often in elderly women without neoplastic epithelial disorders.

Histology: Squamous cell carcinoma (SCC) is the most common malignant tumor of the vulva (95%).

Clinical features: Pruritus is the most common and long-lasting reported symptom of vulvar cancer, followed by vulvar bleeding, discharge, dysuria, and pain.

Therapy: The gold standard for even a small invasive carcinoma of the vulva was historically radical vulvectomy with removal of the tumor with a wide margin followed by an en bloc resection of the inguinal and often the pelvic lymph nodes. Currently, a more individualized and less radical treatment is suggested: a radical wide local excision is possible in the case of localized lesions (T1). A sentinel lymph node (SLN) biopsy may be performed to reduce wound complications and lymphedema.

Prognosis: The survival of patients with vulvar cancer is good when convenient therapy is arranged quickly after initial diagnosis. Inguinal and/or femoral node involvement is the most significant prognostic factor for survival.

Keywords: HPV infection; groin dissection; overall survival; radical vulvectomy; sentinel lymph node biopsy; vulvar cancer.

Publication types

  • Review