A retrospective analysis of Vulva Carcinoma patients treated at a cancer center in Nepal in ten years

Abstract

Introduction: Vulvar cancer is not an uncommon condition, accounting for 4-6% of all female genital tract cancers. More than ninety percent of cancers are squamous cell type. In this study, we have attempted to retrospectively analyze the socio-demographic profile of vulvar cancer patients managed at BP Koirala Memorial Cancer Hospital. Material and methods: This is a descriptive cross-sectional study, that altogether included 77 patients from January 2009 to December 2019 diagnosed with vulvar cancer conducted at BP Koirala Memorial Cancer Hospital, Nepal. All the demographic and clinicopathological data were collected and analyzed using SPSS 16.0 software. Tumor staging was standardized according to the International Federation of Gynecology and Obstetrics (FIGO) staging system. Quantitative data were represented as mean and standard deviation whereas categorical variables were expressed as frequencies and percentages of an appropriate denominator.   Results: Among 77 patients, the median age was 55 years. Most were married (97.4%, n=75), farmers (53.2% n=41), smokers (45.45%, n=35), had poor personal hygiene (65.6%, n=50) and illitrate (61%, n=47). The most common presentation was ulcer or growth (88.31%, n=68). Inguinal lymph nodes were palpable in 80.5% (n=62) of patients, out of which 26% (n=20) had fixed and fungating lymph nodes. Most diagnosed clinical was stage III (40.25%, n=31), stage IV (27%, n=21), stage II (19.48%, n=15) and Stage I (13%, n =10).  The most common histological grading was moderately differentiated SCC (50.6%, n=39). Management was surgical in 72.72% (n=56) and rest 27.27%(n=21) were sent for chemoradiation. The most common postoperative complications were lymphedema (27%, n= 15) and wound infections (12.5%, n=7). Recurrence observed in 28.57% (n=22) of cases. Conclusion: Vulvar cancer is more common among smokers and farmers. The disease is already locally advanced at the time of diagnosis. However, surgery is the main modality of treatment.