Invasive cancer in the vulvar region

During the past 25 years there has been a tenfold increase in the incidence of vulvar cancer in Denmark. For this reason a material of 195 patients treated during the period 1960-77 is reviewed. There had been a considerable delay in treatment, due partly to the patients and partly to the doctor first seen. The five-year survival rate was 63.3%, corrected 84.2%. The prognosis is highly influenced by the size of the tumor, its appearance, the presence of unilateral or bilateral metastasization to the inguinal nodes, the histological type, and localization of the tumor. On the basis of these features, it is possible to single out groups having a particularly poor prognosis in whom the surgical treatment is insufficient and ought to be supplemented. Clinical assessment of the inguinal lymph nodes carries a considerable uncertainty, yet the FIGO staging is based mainly upon this assessment. This goes some way towards explaining why no prognostic differences were found between stages I, II, and III. Postoperative staging based upon the histological diagnosis would provide greater prognostic certainty.