Clinical Analysis Of Vulva Carcinoma

Objective:The purpose of this study is to understand the incidence,clinical manifestations,diagnosis,treatment,survival and prognosis factors in order to avoid risks of vulva carcinoma.Methods:Clinical data of all the patients admitted with vulva carcinoma of our department of Gynecology of First affiliated hospital of Kunming medical university from 2004 to 2017 were retrospectively analyzed.Results:During 13 years,our hospital treated 9 patients of vulva carcinoma.The age was between 43 to 83 years old,mean was 57.44 years old(57.44�13.42).Among them 7(77.78%)patients diagnosed with squamous cell carcinoma of vulva(1 with metastasis to left groin LN),1(11.11%)patient of Basal cell carcinoma of vulva and 1(11.11%)of Melanoma of vulva(relapse after chemotherapy).Among them,7 patients had symptoms of vulvar pain and vulva mass,3 had vulvar pruritus,1 had vaginitis,leucorrhea with per vaginal bleeding.Gynecological examination of 9 patients showed:4 patients had lesions<2cm and 5 patients had lesions>2cm,among whom 3 had cauliflower like mass,2 had hyper-pigmented mass,1 had ulcer at right labia minora near urethra and 3 had vulvar mass.According to FIGO staging 3 patients belongs to stage I A,4 patients belongs to stage IB,1 patient belongs to stage III and one patient's stage could not be assisted.According to histopathology grading 3 patients are grade G1,4 patients are grade G2 and 2 patients are grade GX.Surgical treatment of 2 patients with local tumor resection,3 patients had vulvectomy,1 patient had hysterectomy with vulvectomy,1 patient had local radical vulvectomy,1 patient had radical vulvectomy with B/L groin LN resection,1 patient left hospital without surgery and lost contact,1 patient had vulvectomy in other hospital.After surgery 1 patient received both chemotherapy and radiotherapy,5 patients did not receive any of chemotherapy or radiotherapy,1 patient was confused about treatment and 2 were lost contact.2 of 9 patients were lost to follow up since their primary diagnosis and their current status in unknown.Remaining 7 had regular follow up and among them 3 are alive without recurrence of disease,2 are alive with recurrence and metastasis retreated,1 is alive with disease(cervical cancer)and 1 patient died(from relapse of VSCC with metastasis to right and left groin).Conclusion:With the proper education and advice to seek medical treatment with any of the symptoms such as long-term vulvar pruritus,genital ulcers/warts/mass,vulvar pain,any changes of skin of vulva,pigmented lesions,early detection of pre-cancerous condition can be done and early treatment can decrease the morbidity of females.Avoiding certain risk factors like cigarette smoking,obesity,maintain genital hygiene,monitoring diabetes and hypertension,regular cancer screening tests,if HPV positive then starting the treatment early with regular follow ups,can lower the risk of Vulva carcinoma.Biopsy must be performed on any suspicious lesion of vulva for proper diagnosis and treatment.The prognosis of patients with vulva carcinoma is good when detected early and treated in time.