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ASHEVILLE, N.C. -- Vulvar cancers account for only 3%-5% of all gynecologic neoplasias, but routine screening is simple and worthwhile, particularly in patients at risk, Dr. William P. Irvin Jr. said at the annual Southern Obstetric and Gynecologic Seminar.
The typical patient with vulvar cancer has low parity and is white, postmenopausal, hypertensive, and obese, he said, noting that obesity is one of the greatest risk factors.
Obese women tend to be plagued with chronic inflammatory conditions of the vulva. Longstanding yeast infections, lichen sclerosus, vulvar dystrophy associated with cellular atypia, and granulomatous diseases of the vulva all appear to predispose patients to vulvar cancer, said Dr. Irvin of the University of Virginia Health System in Charlottesville.
When vulvar cancer is caught early, treatment is generally simple and is confined to wide local excision. The survival rate is 90% if it is caught at stage I. 'When it is caught later and lesions are more than 2 cm in diameter and more than 1 mm in depth, vulvectomy is usually necessary.
The 5-year survival rate is 80% with stage II disease, 30% with stage III disease, and 15% with stage IV disease.
Vulvar cancer is a ...