Vulvar squamous cell carcinoma

Area of Science:

• Gynecologic Oncology
• Dermatology
• Oncology

Background:

• Squamous cell carcinoma of the vulva is a rare malignancy primarily affecting elderly women.
• Key risk factors include advanced age, immunosuppression, vulvar dystrophy, vulvar intraepithelial neoplasia (VIN), and a history of human papillomavirus (HPV) infection or cervical cancer.
• Early detection is possible, but delays in diagnosis and treatment lead to advanced-stage disease in one-third of cases.

Purpose of the Study:

• To review the epidemiology, risk factors, and evolving treatment strategies for squamous cell carcinoma of the vulva.
• To highlight recent advancements in managing vulvar cancer, focusing on improved survival rates and reduced morbidity.
• To identify future challenges in the management and prevention of advanced vulvar cancer.

Main Methods:

• Literature review of squamous cell carcinoma of the vulva.
• Analysis of historical and current treatment modalities, including surgical approaches, radiotherapy, and chemotherapy.
• Evaluation of treatment outcomes, focusing on survival rates and complication profiles.

Main Results:

• Standard en bloc dissection achieved high survival rates (up to 90% 5-year survival without lymph node metastases) but with significant complications.
• Current individualized treatment approaches tailor surgery based on tumor characteristics, often combined with radiotherapy, maintaining high survival rates with lower complication rates.
• Chemotherapy's role in advanced vulvar cancer is under investigation.

Conclusions:

• Modern treatment strategies for vulvar cancer achieve high survival rates with less extensive surgery and reduced complications.
• Improving the management of advanced disease and preventing large lesions through reduced treatment delays are critical future challenges.
• Enhanced education for healthcare workers and the public is essential to mitigate diagnostic and treatment delays.