Carcinoma of the vulva accounts for approximately 5% of all gynecologic malignancies. The incidence of this disease seems to be increasing slightly. The majority of patients are in the their sixties and seventies at the time of presentation. In recent years there seems to be an increasing incidence of both preinvasive and invasive vulvar carcinoma in younger women. This may reflect an effect of the prevalence of human papillomavirus in the female population.
The commonest histologic type, squamous cell carcinoma accounts for almost 90% of all cases of malignancy.
Approximate Five Year Survival by Stages
(corrected to exclude death from intercurrent disease)
It should be noted that these figures are approximations of five-year survival data collected from large numbers of patients within a given stage. Extreme caution should be used in attempting to use these data to assign prognosis in an individual case.
Vulva
| Stage I |
80% |
| Stage II |
60% |
| Stage III |
20-30% |
| Stage IV |
<5% |
Common Errors in the Diagnosis and Management of Gynecologic Malignancies
- Failure to perform a complete history and physical examination.
- Over-reliance on diagnostic examinations and under-reliance on clinical suspicion and physical findings.
- Failure to perform a pelvic examination as part of the initial assessment.
Site Specific Errors
Lesions on the vulva not responding to conservative therapy should be biopsied. Unfortunately, many patients with carcinoma of the vulva experience a significant delay in having this diagnosis made from when first they seek medical attention.
Revised Mar 2000