Retrospective analysis of surgically treated cases of squamous cell carcinoma vulva

Abstract

Context: Vulvar carcinoma accounts for 3%–5% of gynecologic malignancies. The past three decades has observed changes in the trends of clinical characteristics and treatment modalities used in managing this disease. Aims: The aim of the present study is to analyze the clinic-pathological characteristics and survival of women with squamous cell carcinoma vulva who underwent primary surgical management. Settings and Design: This was a retrospective observational study. Subjects and Methods: Case records of 30 consecutive patients with squamous cell carcinoma of vulva during the period of 2010–2016 were retrospectively reviewed and their clinical profile, treatment details, complications, and survival were analyzed. Statistical Analysis Used: Kaplan–Meier survival analysis, followed by logrank test, was used for survival outcome, and Cox proportional hazard model was used to assess significant risk factors. Results: The mean age of patients was 58 ± 12.9 years. The most common symptom was growth over vulva (73.3%), itching (63.3%), and nonhealing vulval ulcer (26.6%). The most common site for disease was labia majora. The surgical treatments ranged from wide local excision to radical vulvectomy. Postoperative adjuvant therapy was required for 16 patients. The median (95% confidence interval [CI]) overall survival was 27 (21.7–32.2) months. Five-year survival probability for early-stage disease (I + II) was 49% (95% CI: 12.9, 78.4) and for advanced disease (III + IV) was 24.8% (95% CI: 4.8, 42.6). Lymph node-positive status was found to have a significant impact on survival (hazard ratio of 4.9 [95% CI: 1.15–21.02, P = 0.02]). Conclusions: Despite advances in detection and management modalities, the survival for vulval malignancies has not improved.