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The Journal of Obstetrics and Gynecology of India

, Volume 69, Issue 6, pp 541–545 | Cite as

An Overview of Vulvar Cancer: A Single-Center Study from Northeast India

  • Megha NandwaniEmail author
  • D. Barmon
  • Dimpy Begum
  • Haelom Liegise
  • A. C. Kataki
Original Article
  • 10 Downloads

Abstract

Study

Carcinoma vulva is a rare cancer of the female genital tract. It mostly presents in postmenopausal women. The treatment of vulvar cancer is surgery, chemoradiation, radiotherapy or a combination of all modalities. Here, we present a study of 33 cases of carcinoma vulva over a period of 2 years at a Northeast India regional cancer institute describing its demographic features and treatment outcomes.

Methodology

A retrospective cohort study of vulvar cancer diagnosed at Northeast India regional cancer institute from January 2017 to December 2018.

Results

A total of 33 cases of biopsy proven carcinoma (Ca) vulva were studied. Maximum number of cases belonged to the age group: 60–69 years (39.4%). 66.67% cases had palpable inguinal lymph nodes at presentation, and 100% had squamous cell carcinoma on histopathology. Maximum number of cases belonged to stage III (44.8%), and least number of cases belonged to stage IV (10.3%) of FIGO 2009 staging of Ca vulva. 87.9% cases underwent treatment, and 12.1% were lost to follow-up. Out of the cases who underwent treatment, 55.2% cases were taken up for primary surgery and 44.8% cases for primary radiotherapy. 75% cases who underwent surgery received adjuvant radiotherapy. No complication was seen in patients post-radiation. But, 6.25% patients post-surgery developed lymphocyst and 18.75% patients developed wound necrosis (p > 0.05).

Conclusion

Vulvar cancer is not a common malignancy of the female genital tract that presents in sixth and seventh decades of life and often with palpable inguinal lymph nodes. Though early stages of Ca vulva are treated by surgery, the incidence of immediate postoperative complications in our study was more as compared to post-radiotherapy. Also, maximum patients in the present study post-surgery received adjuvant radiotherapy. Thus, radiotherapy can be considered as the primary treatment modality for patients with early as well as advanced vulvar carcinoma.

Keywords

Carcinoma vulva Squamous cell carcinoma Lymphocyst Chemoradiation 

Notes

Acknowledgements

I would like to thank my professors and seniors for helping me in publishing this manuscript and my parents for their continuous encouragement and support.

Compliance with Ethical Standards

Conflict of interest

The authors declare no conflict of interest.

Ethical Standard

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008 (5). Informed consent was obtained from all patients for being included in the study.

Human and Animal Rights

This article does not contain any studies with human or animal subjects.

References

  1. 1.
  2. 2.
    Siegel R, Naishadham D, Jemal A. Cancer statistics, 2013. CA Cancer J Clin. 2013;63(1):11–30.CrossRefGoogle Scholar
  3. 3.
    Gunther V, Alkatout I, Lez C, et al. Malignant melanoma of the urethra: a rare histologic subdivision of vulvar cancer with a poor prognosis. Case Rep Obstet Gynecol. 2012;2012:385175.PubMedPubMedCentralGoogle Scholar
  4. 4.
    Thaker NG, Klopp AH, Jhingran A, et al. Survival outcomes for patients with stage IVB vulvar cancer with grossly positive pelvic lymph nodes: time to reconsider the FIGO staging system? Gynecol Oncol. 2015;136(2):269–73.CrossRefGoogle Scholar
  5. 5.
    Nooij LS, Ongkiehong PJ, van Zwet EW, et al. Groin surgery and risk of recurrence in lymph node positive patients with vulvar squamous cell carcinoma. Gynecol Oncol. 2015;139(3):458–64.CrossRefGoogle Scholar
  6. 6.
    Deka P, Barmon D, Shribastava S, et al. Prognosis of vulval cancer with lymph node status and size of primary lesion: a survival study. Journal of mid-life health. 2014;5:10–3.CrossRefGoogle Scholar
  7. 7.
    Viswanathan C, Kirschner K, Truong M, et al. Multimodality imaging of vulvar cancer: staging, therapeutic response, and complications. AJR Am J Roentgenol. 2013;200(6):1387–400.CrossRefGoogle Scholar
  8. 8.
    Okolo CA, Odubanjo MO, Awolude OA, et al. A review of vulvar and vaginal cancer in Ibadan, Nigeria. N Am J Med Sci. 2013;6(2):76–81.Google Scholar
  9. 9.
    Russell AH, Horowitz NS (2016) Cancers of the Vulva and Vagina. In: Clinical radiation oncology, pp. 1230–1263.e6.  https://doi.org/10.1016/b978-0-323-24098-7.00060-5.Google Scholar
  10. 10.
    Zweizig S, Korets S, Cain JM. Key concepts in management of vulvar cancer. Best Pract Res Clin Obstet Gynaecol. 2017;28(7):959–66.CrossRefGoogle Scholar
  11. 11.
    Morotti M, Menada MV, Boccardo F, et al. Lymphedema microsurgical preventive healing approach for primary prevention of lower limb lymphedema after inguinofemoral lymphadenectomy for vulvar cancer. Int J Gynecol Cancer. 2013;23:769–74.CrossRefGoogle Scholar
  12. 12.
    Dellinger TH, Hakim AA, Lee SJ, et al. Surgical management of vulvar cancer. J Natl Compr Canc Netw. 2017;15:121–8.CrossRefGoogle Scholar
  13. 13.
    Palumbo AR, Fasolino C, Santoro G, et al. Evaluation of symptoms and prevention of cancer in menopause: the value of vulvar exam. Transl Med UniSa. 2016;15:74–9.PubMedPubMedCentralGoogle Scholar
  14. 14.
    Hansen BT, Campbell S, Nygard M. Long-term incidence trends of HPV-related cancers, and cases preventable by HPV vaccination: a registry-based study in Norway. BMJ Open. 2018;8:e019005.CrossRefGoogle Scholar
  15. 15.
    Allbritton JI. Vulvar neoplasms, benign and malignant. Obstet Gynecol Clin North Am. 2017;44:339–52.CrossRefGoogle Scholar

Copyright information

© Federation of Obstetric & Gynecological Societies of India 2019

Authors and Affiliations

  1. 1.Dr. B Borooah Cancer InstituteGuwahatiIndia

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