[Clinical analysis of 105 cases of vulvar cancer]

Vulvar cancer has a low frequency (4-5%) compared to other genital cancers. It should be considered as a skin tumor and its detection is possible in an early stage. However, because of patients' and doctors' delay, one in three vulvar cancers is not treated before an advanced stage.

To estimate clinical and histopathological features of vulvar cancer.

We analysed 105 women with a primary malignant vulvar disease treated operatively in our Dept. in the years 1991-2002. In the group there were 82 invasive tumours (80 squamous and 2 solid) and 23 intraepithelial cancers.

The mean age in the group of intraepithelial cancer was 53.2 +/- 13.2 years, and in the group of invasive disease 65.0 +/- 11.7 years. The most common symptoms were ache (40.0%) and pruritus of the vulva (35.2%). 33.3% women were asymptomatic. Most of cancers were localised on the large pudendal lip (71.4%). Inguinal node dissections performed on invasive cancer patients showed negative nodes in 57 cases and positive in 25 cases. Sensitivity, specificity, positive and negative predictive value for clinical detection of metastatic cancer in the inguinal nodes were 60%, 82.4%, 60%, 82.4% respectively. The distribution by stage included Stage 0--21.9%; Stage I--19.0%; Stage II--31.4%; Stage III--11.5%; and Stage IV--19.0%. The commonest surgical procedure was a simple vulvectomy with a bilateral inguinal lymphadenectomy.

Vulvar squamous cell carcinoma predominantly affects older women. It benefits from early detection, and their morbidity is decreased by early treatment. It is necessary to educate patients to improve the detection of vulvar cancer.