[Clinical study of 84 primary vulvar carcinomas]

Between 1949 and 1987, 84 cases of primary vulvar malignancy were treated at the Cancer Institute Hospital. These cases accounted for 0.8% of the total number of gynecologic malignancies at our hospital during the same period. The clinicopathological findings were described. The mean age of the 84 cases was 61.7 years. The most frequent symptom was a vulvar mass, seen in 35 cases (41.7%). In preoperative cytologic examination of vulvar smears, 44/78 cases (56.4%) had suspected malignancy. Histopathologically, 57 cases (67.9%) were found to be squamous cell carcinoma. According to FIG0 staging system, there were 4 (4.8%) stage 0 tumors, 11 (13.0%) stage I tumors, 25 (29.8%) stage II tumors, 41 (48.8%) stage III tumors, and 3 (3.6%) stage IV tumors. The patients were treated by operation and/or irradiation. The five-year survival rate was 51.4% (36/70) in all stages. The five-year survival rate was 66.7% (2/3) in stage 0 cases, 87.5% (7/8) in stage I, 78.9% (15/19) in stage II, 28.9% (11/38) in stage III, and 50.0% (1/2) in stage IV, respectively. In patients treated by radical vulvectomy, the five-year survival rate was 26.7% (4/15) when there was inguinal nodal metastasis, and 73.7% (14/19) when there was no inguinal nodal metastasis. The five-year survival rate was 59.5% (25/42) in cases treated by operation and was 39.3% (11/28) in cases treated by irradiation. In preoperative adjuvant chemotherapy, the histopathological effect was 44.4% (4/9). In conclusion, the first choice for treatment of vulvar malignancy was considered the operative method.