Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Nov 22;16(11):e74236.
doi: 10.7759/cureus.74236. eCollection 2024 Nov.

Treatment Outcomes of Vulvar Cancer: Our Experience From a Tertiary Care Center in Eastern India

Tashbihul Azhar  1 , Shiv Rajan  2 , Naseem Akhtar  2 , Vijay Kumar  2 , Sameer Gupta  2 , Jagjit Pandey  1 , Rebba Ephraim  1 , Pravin Kumar  1
Affiliations

Treatment Outcomes of Vulvar Cancer: Our Experience From a Tertiary Care Center in Eastern India

Tashbihul Azhar et al. Cureus. .

Abstract

Introduction: The vulva is the external genitalia in females. Vulvar carcinoma is a rare entity, with squamous cell carcinoma as the most common histology while basal cell carcinoma, extra-mammary Paget's disease, and melanoma are still rarer subtypes. Treatment often comprises a multidisciplinary approach with surgery being the mainstay, followed by adjuvant therapy, depending upon pathological stage and other factors. Neoadjuvant treatment is considered in locally advanced cases where upfront surgery would not achieve adequate margin or organ preservation (urethra and anal canal). Due to the rarity of the disease and initial presentation at advanced stages in third-world countries, it is important to have strict treatment protocols with identifications of various prognostic factors and regular timely follow-up, which would, in turn, improve treatment outcomes. Here, we are presenting our institutional retrospective cohort spanning over eight years.

Methods: This is a retrospective descriptive study done in the department of surgical oncology of a tertiary care cancer center in India from January 2016 to April 2024. A total of 21 patients with histologically proven diagnoses of vulvar cancer were included in the analysis. Stage of disease, treatment modalities used, and disease outcomes in terms of survival were tabulated. Statistical analysis was done using SPSS version 17 for Windows (SPSS Inc., Chicago, IL).

Results: The estimated five-year overall survival was ≈71% using Kaplan-Meier analysis. On univariate analysis (testing other factors), using a log-rank test, neither stage nor nodal positivity were significant prognostic factors for overall survival. Given the small number of cases, multivariate analysis was not possible.

Conclusion: In carcinoma of the vulva, treatment should be individualized with multidisciplinary cooperation. In many series, stage, nodal positivity, and extracapsular extension are found to be significant prognostic factors, though our results did not correspond with these data probably due to a small cohort. The paucity of data, especially from India and other developing countries, necessitates the need for more studies, preferably multicentric, keeping in mind the low prevalence of disease.

Keywords: chemotherapy; female vulvar cancer; flap necrosis; human papillomavirus; infection; radiotherapy; seroma; squamous cell carcinoma; vulva.

PubMed Disclaimer

Conflict of interest statement

Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. AIIMS, Patna, India issued approval Exempt. This is an observational study based on retrospective data of patients who were treated as per international guidelines. No experimental interventions were done on any patient and they were just followed up for their survival outcomes. Data were compared for oncological outcomes with the available literature, hence ethical approval was not mandated (given the retrospective observational nature of the study). Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Five-year survival curve.
OS: overall survival.
See this image and copyright information in PMC

References

    1. American Cancer Society. Cancer facts & figures 2020. 2020. https://www.cancer.org/research/cancer-facts-statistics/all-cancer-facts... https://www.cancer.org/research/cancer-facts-statistics/all-cancer-facts...
    1. Trends of vulvar cancer. Chhabra S, Bhavani M, Deshpande A. J Obstet Gynaecol. 2014;34:165–168. - PubMed
    1. Cancer stat facts: vulvar cancer. 2024. https://seer.cancer.gov/statfacts/html/vulva.html https://seer.cancer.gov/statfacts/html/vulva.html
    1. A cohort study of vulvar cancer over a period of 10 years and review of literature. Singh N, Negi N, Srivastava K, Agarwal G. https://pubmed.ncbi.nlm.nih.gov/28244472. Indian J Cancer. 2016;53:412–415. - PubMed
    1. Sobin LH, Gospodarowicz MK, Wittekind C. Vol. 7. New York, NY: Wiley-Blackwell; 2009. TNM Classification of Malignant Tumours, 7th edition; p. 2010.

LinkOut - more resources