Clinico-pathological Characteristics and Treatment Modalities of Vulvar Cancer: A Retrospective Analysis

Abstract

Background: Vulvar cancer is one of the rare malignancies of the female genital tract. Vulvar cancer is predominantly a disease of post-menopausal multiparous women. Objective: The aim of this study was to analyse and report the clinico-pathological features and treatment modalities of patients with vulvar cancer treated at National Institute of Cancer Research and Hospital (NICR&H), Dhaka, Bangladesh. Methods: This was a cross- sectional observational study conducted among 96 vulvar cancer cases treated at National Institute of Cancer Research and Hospital (NICR&H), Dhaka, Bangladesh from 2015 to 2020. The medical records of patients with vulvar cancer were retrospectively reviewed after obtaining approval from the Institutional Review Board (IRB). Clinical details of all vulvar cancer patients and treatment given were collected from the hospital records and were reviewed retrospectively. Results: A total of 96 patients with vulvar cancer were included for this retrospective analysis. The median age was 50 years (range, 12- 85 years) with a mean (±SD) of 50.50±15.12 years. Stages of the disease were: stage I: 27.1% patients; stage II: 22.9% patients; stage III: 30.3% patients; stage IV: 16.7% patients; and unknown stage: 3.1% patient as per International Federation of Gynecology and Obstetrics (FIGO) staging system. Histopathologically, squamous cell carcinoma (SCC) was the most common histologic type (84.4%) followed by adenocarcinoma (5.2%), melanoma (4.2%), basal cell carcinoma (3.1%), and others (3.1%). Most of the patients (45.8%) were treated by surgery with or without adjuvant radiotherapy. About 24.0% of patients were treated primarily by radiotherapy and/or chemo-radiotherapy. Conclusion: Management of vulvar cancer requires multidisciplinary team approach, which is available only in tertiary care centres. The treatment of vulvar cancer is surgery, radiotherapy, chemo- radiotherapy or a combination therapy. Treatment should be individualised based on lesions location and histological type. Bangladesh Med Res Counc Bull 2022; 48(1): 64-70