Vulvar cancer: epidemiology, clinical presentation, and management options.

Autor: Alkatout I; Department of Gynecology and Obstetrics, University Hospitals Schleswig-Holstein, Campus Kiel, Kiel, Germany., Schubert M; Department of Gynecology and Obstetrics, University Hospitals Schleswig-Holstein, Campus Kiel, Kiel, Germany., Garbrecht N; Institute for Pathology, University Hospitals Schleswig-Holstein, Campus Kiel, Kiel, Germany., Weigel MT; Department of Gynecology and Obstetrics, University Hospitals Schleswig-Holstein, Campus Kiel, Kiel, Germany., Jonat W; Department of Gynecology and Obstetrics, University Hospitals Schleswig-Holstein, Campus Kiel, Kiel, Germany., Mundhenke C; Department of Gynecology and Obstetrics, University Hospitals Schleswig-Holstein, Campus Kiel, Kiel, Germany., Günther V; Department of Gynecology and Obstetrics, University Hospitals Schleswig-Holstein, Campus Kiel, Kiel, Germany.
Jazyk: angličtina
Zdroj: International journal of women's health [Int J Womens Health] 2015 Mar 20; Vol. 7, pp. 305-13. Date of Electronic Publication: 2015 Mar 20 (Print Publication: 2015).
DOI: 10.2147/IJWH.S68979
Abstrakt: Epidemiology: Vulvar cancer can be classified into two groups according to predisposing factors: the first type correlates with a HPV infection and occurs mostly in younger patients. The second group is not HPV associated and occurs often in elderly women without neoplastic epithelial disorders.
Histology: Squamous cell carcinoma (SCC) is the most common malignant tumor of the vulva (95%).
Clinical Features: Pruritus is the most common and long-lasting reported symptom of vulvar cancer, followed by vulvar bleeding, discharge, dysuria, and pain.
Therapy: The gold standard for even a small invasive carcinoma of the vulva was historically radical vulvectomy with removal of the tumor with a wide margin followed by an en bloc resection of the inguinal and often the pelvic lymph nodes. Currently, a more individualized and less radical treatment is suggested: a radical wide local excision is possible in the case of localized lesions (T1). A sentinel lymph node (SLN) biopsy may be performed to reduce wound complications and lymphedema.
Prognosis: The survival of patients with vulvar cancer is good when convenient therapy is arranged quickly after initial diagnosis. Inguinal and/or femoral node involvement is the most significant prognostic factor for survival.
Databáze: MEDLINE
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