Invasive Cancer in the Vulvar Region

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Abstract
During the past 25 yr there has been a 10-fold increase in the incidence of vulvar cancer in Denmark. For this reason 195 patients treated between 1960-1977 were reviewed. There was a considerable delay in treatment due partly to the patients and partly to the doctor first seen. The 5 yr survival rate was 63.3%, corrected 84.2%. The prognosis is highly influenced by the size of the tumor, its appearance, the presence of unilateral or bilateral metastasization to the inguinal nodes, the histological type and localization of the tumor. On the basis of these features, it is possible to single out groups having a particularly poor prognosis in whom the surgical treatment is insufficient and should be supplemented. Clinical assessment of the inguinal lymph nodes carries a considerable uncertainty, yet the International Federation of Gynecology and Obstetrics staging is based mainly on this assessment. This goes some way towards explaining why no prognostic differences were found between stages I, II and III. Postoperative staging based on the histological diagnosis would provide greater prognostic certainty.

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