Accounts for 5% of all female genital cancers and 1% of all malignancies in women.
2500 cases per year and 500 deaths per year in the U.S.
Any vulvar lesion discovered by a physical examination should be biopsied to rule out a neoplasm.
Most vulvar neoplasia are diagnosed in early stages.
Histology include melanoma, extramammary Paget’s, disease, Bartholin gland adenocarcinoma, verrucous carcinoma, basal cell carcinoma, with most cases being squamous cell carcinoma.
Approximately 39% of patients with vulvar cancer are diagnosed with advanced stages III or IV.
87% of lesions are squamous cancers and 6% are malignant melanoma.
Incidence of squamous cell vulvar cancer 2.5 per 100,000 women.
Risk factors include: increasing age, infection with HPV, cigarette smoking, inflammatory conditions affecting the vulva and immunodeficiency.
Standard treatment for early stage squamous cell carcinoma is wide local excision and unilateral or bilateral inguinofemoral lymphadenectomy.
Well significant prognostic factor for vulvar squamous cell carcinoma is lymph node status.
Factors associated with poor outcomes besides lymph nodes status include age, tumor diameter, tumor depth, tumor class, histologic grade, lymphovascular space invasion, margin distance, and clitoral involvement.
Half a women who undergo surgical treatment for vulvar cancer have wound complications.
Lymphedema and cellulitis following lymphadenectomy, can be lifelong issues.
Sentinel lymph node biopsy is a reasonable alternative to inguinal femoral lymphadenectomy in selected patients.
Studies have demonstrated a superiority of groin and pelvic radiotherapy compared to pelvic lymphadenectomy in patients undergoing radical pelvic vulvectomy with groin metastases.