Squamous Cell Vulvar Cancer Research Articles

Squamous cell carcinoma of the vulva in pregnancy

Two women presenting with invasive squamous cell cancer of the vulva during pregnancy are reported. The first patient was successfully treated by radical vulvectomy 2 weeks after cesarean section delivery; the second patient died of disseminated cancer despite radical vulvectomy and postoperative radiation therapy. In the second case the diagnosis was not established until 3 months after delivery. Only 12 cases of invasive squamous cell vulvar cancer during pregnancy have been previously reported. Liberal use of punch biopsy for any suspicious vulvar lesions is mandatory to enhance the potential for early diagnosis and successful treatment.

Multiple primary tumours in women with vulvar neoplasms: a case-control study.

We sought to determine whether women with in situ or invasive squamous cell vulvar cancer were more likely than other women to have had a previous or concurrent tumour at other anogenital sites. One hundred and fifty-eight women with vulvar cancer were identified who were first diagnosed during 1980-1985, were ages 18-79 years at that time, and were residents of one of three counties in western Washington. Two control groups were selected: (1) from records of hospital pathology departments, a sample of 113 women with certain benign conditions of the vulva; (2) through random digit dialing, a sample of 212 women from the general population of these counties. Information on a history of other cancers, and on sexual, reproductive, medical, and demographic characteristics was collected from cases and controls in at-home interviews. Cases were more likely to report a history of other anogenital cancers than were controls, with relative risks of 3.5-29.8, depending on the type of case group and type of control. These associations were not explained by case-control differences in demographic characteristics or frequency of cervical screening. On the other hand, prior or concurrent non-anogenital cancers were equally common in cases and controls. These results support the hypothesis that the different anogenital cancers have at least one aetiology in common.

Positive groin lymph nodes in superficial squamous cell vulvar cancer: A gynecologic oncology group study

The term microinvasive carcinoma is inappropriate when applied to all vulvar cancers ≤5 mm thick because approximately 50% of vulvar carcinomas are no thicker than 5 mm and 20% of these superficial tumors metastasize to the lymph nodes. The significant predictors of groin node metastases in patients with suparficial vulvar cancer are tumor thickness, histologic grade (proportion of undifferentiated tumor pattern), capillary-like space involvement with the tumor, clitoral or perineal location, and clinically suspicious nodes, according to the linear logistic model analysis of clinicopathologic data in 272 women. No lymph node metastases occurred in approximately one fourth of patients with a combination of low-risk factors: no clinically suspicious nodes, negative capillary-like space, and nonmidline vulvar cancers that were either grade 1 and 1 to 5 mm thick or grade 2 and 1 to 2 mm thick. In contrast, all 10 patients with clinically suspicious nodes and grade 4 tumors had positive groin nodes. The risk of lymph node metastases in best determined by simultaneous evaluation of all risk factors rather than a single factor such as tumor thickness.

Positive groin lymph nodes in superficial squamous cell vulvar cancer

Abstract The term microinvasive carcinoma is inappropriate when applied to all vulvar cancers ≤5 mm thick because approximately 50% of vulvar carcinomas are no thicker than 5 mm and 20% of these superficial tumors metastasize to the lymph nodes. The significant predictors of groin node metastases in patients with suparficial vulvar cancer are tumor thickness, histologic grade (proportion of undifferentiated tumor pattern), capillary-like space involvement with the tumor, clitoral or perineal location, and clinically suspicious nodes, according to the linear logistic model analysis of clinicopathologic data in 272 women. No lymph node metastases occurred in approximately one fourth of patients with a combination of low-risk factors: no clinically suspicious nodes, negative capillary-like space, and nonmidline vulvar cancers that were either grade 1 and 1 to 5 mm thick or grade 2 and 1 to 2 mm thick. In contrast, all 10 patients with clinically suspicious nodes and grade 4 tumors had positive groin nodes. The risk of lymph node metastases in best determined by simultaneous evaluation of all risk factors rather than a single factor such as tumor thickness.

Prognostic parameters in invasive vulvar cancer

Prognostic parameters were studied in 66 patients with invasive squamous cell vulvar cancer treated with radical vulvectomy and bilateral inguinal and femoral lymph node dissection. Patients with metastases in regional lymph nodes had a 46% survival for 3 or more years compared to 76.3% in patients without evidence of nodal spread. The presence of lymph nodal metastases correlated directly with stage, lesion size, depth of invasion, and the presence of lymph-vascular space involvement with tumor. However, even the best prognostic groups had a 30% incidence of positive nodes. No patient with less than 5 mm of stromal invasion without vascular involvement had positive nodes. These preliminary data suggest that careful observation of vascular space invasion by tumor cells together with measurement of the depth of stromal invasion may help define a group of patients with vulvar cancer that can be treated conservatively. Further studies are needed to confirm these findings in larger numbers of patients.