Clinical features of Jewish Israeli patients with squamous cell carcinoma of the vulva

Abstract

The clinical features of all 150 Jewish patients with squamous cell carcinoma of the vulva diagnosed in Israel during a 13-year period (1961-73) are presented. As in other studies, the frequencies of diabetes, hypertension, atherosclerosis and early onset of menopause were relatively high, and there was a long time lag from onset of symptoms to diagnosis. The most common complaint was pruritus vulvae, and the labia were the most common site of the primary lesion. The predictive value of clinical lymph node examination was reasonably good; lymph node involvement adversely affected survival. In contrast to other studies, the frequency of nulliparity and venereal diseases was low and the most common second primary malignancy was carcinoma of the breast. During the period reviewed, the surgical approach was mainly conservative and the postoperative mortality high, yielding a low 5-year survival rate. We attribute this to the lack of trained gynecologic oncologists during the period reviewed. Preliminary data indicate that in recent years a more aggressive surgical approach is being used and an improved 5-year survival rate achieved.