Vulvar Cancer

Vulvar Cancer

Vulvar cancer, a condition affecting approximately 5% of gynecological cancers and around 0.6% of all cancers in women (1,2), is commonly found in women who have reached menopause.

The causes of vulvar cancer are multifactorial and include factors such as human papillomavirus (HPV) infection, prior presence of vulvar intraepithelial neoplasia (VIN), prior presence of cervical intraepithelial neoplasia (CIN), lichen sclerosus, smoking, alcohol consumption, obesity, compromised immune system, and a history of previous cervical cancer (3,4). Vulvar cancer can be classified into two types (5):

Type 1: Basaloid or Warty Type

Type 2: Keratinizing Type

Diagnostic Process:

The diagnostic process involves the extraction of tissue samples for pathological examination to determine the type of cancer in the oral and anal regions. Squamous Cell Carcinoma comprises approximately 90% of cases, followed by Melanoma at 2-4%, and Basal Cell Carcinoma at 2-3%.

Staging of Anal Cancer (6 Stages)

Stage 1: The disease is confined to the anal region.

Stage 1A: The tumor measures ≤ 2 centimeters and has spread into the superficial layer by ≤ 1 millimeter.

Stage 1B: The tumor measures > 2 centimeters and has spread into the superficial layer by > 1 millimeter.

Stage 2: The tumor is unrestricted in size and has spread to adjacent organs (one of the lower third of the urethra, and/or one of the lower third of the anal canal, and/or perianal skin).

At stage 3, the disease marks are unrestricted in size and spread to adjacent organs (one-third of the lower portion of the urethra and/or one-third of the lower part of the birth canal and/or the bladder). Additionally, there is dissemination to the lymph nodes.

Stage 3A: Dissemination to one or more pelvic lymph nodes with a size of ≥ 5 millimeters or dissemination to 1-2 pelvic lymph nodes with a size of < 5 millimeters.

Stage 3B: Dissemination to two or more pelvic lymph nodes with a size of ≥ 5 millimeters or dissemination to three or more pelvic lymph nodes with a size of < 5 millimeters.

Stage 3C: Dissemination to pelvic lymph nodes and extra-capsular spread.

At stage 4:

Stage 4A: Disease spread to the upper part of the urethra and/or the upper part of the birth canal, bladder lining, and the adjacent bones.

Stage 4B: Dissemination to other organs.

References:

1. Siegel RL, Miller KD, Jemal A. Cancer Statistics, 2017. CA Cancer J Clin 2017;67:7-30

2. U.S. Cancer Statistics Working Group. United States Cancer Statistics

3. Madsen BS, Jensen HL, et al. Risk factors for invasive squamous cell carcinoma of the vulva and vagina—population-based study in Denmark. Int J Cancer 2008;122:2827-2834

4. Brinton LA, Thistle JE, et al. Epidemiology of vulvar neoplasia in the NIH-AARP study. Gynecol Oncol 2017;145:298-304

5. Crum CP. Carcinoma of the vulva: epidermiology and pathogenesis. Obstet Gynecol 1992; 79:448-54

6. Pecorelli S. Revised FIGO staging for carcinoma of the vulva, cervix, and endometrium. Int J Gynecol Obstet 2009;105:103-4__

For more information, please contact the Obstetrics and Gynecology Department, located on the second floor of Building 2.

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