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Vulvar cancer natural history

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Monalisa Dmello, M.B,B.S., M.D. [2] Syed Musadiq Ali M.B.B.S.[3]


Overview

If left untreated, patients with vulvar cancer may progress to develop ulcer on vulva or wart-like patches on vulva and chronic pruritus of the vulva. Common complications of vulvar cancer include fistula and metastasis. Prognosis is generally good, and the 5 year survival rate of patients with vulvar cancer is approximately 71.2%.

Natural history

  • Patient has early symptoms like ulcer on vulva, chronic pruritus of the vulva, and wart-like patches on vulva.[1]
  • As the tumor grows larger, patient may notice symptoms like unusual bleeding or discharge from the lesion, large mass on the vulva, dysuria, and dyspareunia.
  • In advanced disease, metastases may be present in the abdomen and lungs.
  • The patient may present with dyspnea, cough with blood-stained sputum, persistent pain or discomfort in the chest, edema hands/feet, and inguinal lymphadenopathy.
  • Once the cancer spreads to the other organs, it is most likely fatal.[2]

Complications

Common complications of valvular cancer include:[3][4]

Prognosis

Stage 5-year relative survival (%)
I 93%
II 79%
III 53%
IV 29%

References

  1. Sykes P, Eva L, van der Griend R, McNally O, Blomfield P, Brand A, Tristram A, Bergzoll C, Petrich S, Kenwright D, Payne K, Kellow M, Innes C, Harker D, Perrin L, Cohen P, Jaaback K, Simcock B (February 2019). “Pathological process has a crucial role in sentinel node biopsy for vulvar cancer”. Gynecol. Oncol. doi:10.1016/j.ygyno.2019.02.012. PMID 30814024.
  2. Koh WJ, Greer BE, Abu-Rustum NR, Campos SM, Cho KR, Chon HS, Chu C, Cohn D, Crispens MA, Dizon DS, Dorigo O, Eifel PJ, Fisher CM, Frederick P, Gaffney DK, Han E, Higgins S, Huh WK, Lurain JR, Mariani A, Mutch D, Nagel C, Nekhlyudov L, Fader AN, Remmenga SW, Reynolds RK, Tillmanns T, Ueda S, Valea FA, Wyse E, Yashar CM, McMillian N, Scavone J (January 2017). “Vulvar Cancer, Version 1.2017, NCCN Clinical Practice Guidelines in Oncology”. J Natl Compr Canc Netw. 15 (1): 92–120. PMID 28040721.
  3. Dass PH, Kuper-Hommel MJ (November 2017). “A review of squamous cell vulvar cancers in Waikato region, New Zealand”. N. Z. Med. J. 130 (1465): 19–28. PMID 29121621.
  4. Wiggans A, Coleridge S, Bryant A, Morrison J (April 2019). “Relationship between vulvar symptoms and incidence of vulvar cancer in women referred to a rapid access clinic”. Int J Gynaecol Obstet. doi:10.1002/ijgo.12818. PMID 30932169.
  5. Survival statistics for vulvar cancer. Vulvar cancer. http://www.cancer.ca/en/cancer-information/cancer-type/vulvar/prognosis-and-survival/survival-statistics/?region=ns Accessed on October 1, 2015

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