Clinicopathological Prognostic Factors Influencing Survival Outcomes of Vulvar Cancer

Abstract

Vulva cancer is a rare gynecologic cancer. The latest data from Globocan 2018 showed a crude rate of 1.2 per 100,000 women-year (Bray et al., 2018). The most common histology is squamous cell carcinoma (SCCA) which is classified into two types. The first type is human papillomavirus (HPV) related. This type typically is found with a high-grade squamous cell intraepithelial lesion (HSIL) and is associated with the immunosuppressive state, smoking, and usually occurs in the younger age population. The other type is non-HPV related. The precursor lesion of this type is differentiated vulvar intraepithelial neoplasia (dVIN) usually occurring in postmenopausal women (Bornstein et al., 2016). The standard treatment for early-stage SCCA vulva cancer is composed of the wide local or radical vulvectomy with or without groin node dissection dependent on the depth of the primary lesion. A tumor with an invasion of more than one mm., warrants groin node dissection. Adjuvant treatment with pelvic and/or vulvar radiation is given when the groin node or surgical margins were involved (Tan et al., 2019). Despite radical treatment, the recurrence rates still occurred in a range of 16-40% (Te Abstract