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]

Vulvar cancer Microchapters
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Overview

If left untreated, patients with vulvar cancer may progress to develop ulcer on vulva or wart-like patches on vulva, chronic puritius of the vulva and lichenification. 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

• In younger age group, HPV infection can be the cause of vulvar cancer. Vulvar cancer may be associated vulvar dermatoses, such as lichen sclerosus, especially in older age group.
• Patient has early symptoms like ulcer on vulva, chronic puritius of the vulva, lichenification, and wart-like patches on vulva.
• As the tumor grows larger, patient may notice symptoms like unusual bleeding or discharge from the lesion, large mass on the vulva, dysuria and dysparunia.
• In advanced disease, metastases may be present in the abdomen, 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.

Complications

• Pelvic pain
• Fistula
• Metastasis - usually in the liver and lungs but may occur in other sites

Prognosis

Vulvar cancer is associated with a 5 year survival rate of 71.2%. Following is the table for squamous cell carcinoma of the vulva survival

Stage	5-year relative survival (%)
I	93%
II	79%
III	53%
1V	29%