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      Vulvar cancer in Iran: Retrospective study over 20 years (1998-2018)

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          Abstract

          Background:

          We did not have any data about vulvar cancer — as a fourth cause of gynecological cancer in the worldwide — in our country.

          Study Design:

          Our study is designed to evaluate the frequency, stage and outcome of patients with vulvar cancer.

          Materials and Methods:

          In this retrospective observational study, we studied patients’ records with diagnosis of vulvar cancer who referred to department of gynecology oncology, Emam-Khomeini Hospital (EKH), Tehran, Iran, between January 1998 and December 2018. A total of 106 cases of vulvar cancers were found in the records of outpatient oncology clinic of medical university of Tehran university. Survival was estimated using the Kaplan-Meier analysis with SPSS version of 24.

          Results:

          Mean age of the 106 patients in the study was 59.2 years. The most site of tumor involvement was major labial (39.1%). Vulvar cancer significantly was more in multiparous ( P < 0.001) and menopause patients ( P < 0.001). Squamous Cell Carcinoma was the most pathology of vulvar cancer (72.2%). Ninety patients (84.9%) had surgery as a primary treatment and 48 (53.3%) of these patients received adjuvant radiotherapy or chemoradiation after surgery. Mean duration of patient's follow up was 82.4 ± 68.3 month. Five-year survival of our patients in all stages was 71%.

          Conclusions:

          Our findings are located between developed and underdeveloped countries. Our patients are diagnosed nearly in earlier stages of disease and 84.9%t of them had surgery as a primary treatment, so earlier surgery resulted in good survival of patients.

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          Most cited references22

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          Is Open Access

          Vulvar cancer: epidemiology, clinical presentation, and management options

          Epidemiology Vulvar cancer can be classified into two groups according to predisposing factors: the first type correlates with a HPV infection and occurs mostly in younger patients. The second group is not HPV associated and occurs often in elderly women without neoplastic epithelial disorders. Histology Squamous cell carcinoma (SCC) is the most common malignant tumor of the vulva (95%). Clinical features Pruritus is the most common and long-lasting reported symptom of vulvar cancer, followed by vulvar bleeding, discharge, dysuria, and pain. Therapy The gold standard for even a small invasive carcinoma of the vulva was historically radical vulvectomy with removal of the tumor with a wide margin followed by an en bloc resection of the inguinal and often the pelvic lymph nodes. Currently, a more individualized and less radical treatment is suggested: a radical wide local excision is possible in the case of localized lesions (T1). A sentinel lymph node (SLN) biopsy may be performed to reduce wound complications and lymphedema. Prognosis The survival of patients with vulvar cancer is good when convenient therapy is arranged quickly after initial diagnosis. Inguinal and/or femoral node involvement is the most significant prognostic factor for survival.
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            Trends in incidence and survival of Dutch women with vulvar squamous cell carcinoma.

            Previous studies showed an increase in incidence of vulvar intraepithelial neoplasia (VIN), the premalignant lesion of Vulvar Squamous Cell Carcinoma (VSCC). Furthermore, during the last decades treatment of VSCC became less radical. Considering these changes the aim of this study was to describe trends of incidence and survival of patients with VSCC in the Netherlands.
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              In situ and invasive squamous cell carcinoma of the vulva in Denmark 1978-2007-a nationwide population-based study.

              To determine the incidence of vulvar carcinoma in situ (CIS) and cancer of squamous cell (SC) origin in Denmark in the period 1978-2007.
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                Author and article information

                Journal
                J Family Med Prim Care
                J Family Med Prim Care
                JFMPC
                Journal of Family Medicine and Primary Care
                Medknow Publications & Media Pvt Ltd (India )
                2249-4863
                2278-7135
                April 2019
                : 8
                : 4
                : 1465-1469
                Affiliations
                [1 ] Department of Gynecology Oncology, Vali-Asr Hospital, Tehran University of Medical Sciences, Tehran, Iran
                Author notes
                Address for correspondence: Dr. Azadeh Yousefnezhad, Department of Gynecology Oncology, Tehran University of Medical Sciences, Tehran, Iran. E-mail: Yousefnezhad59@ 123456gmail.com
                Article
                JFMPC-8-1465
                10.4103/jfmpc.jfmpc_145_19
                6510090
                44e4e36f-c56f-4a12-81a1-900ff0d91b32
                Copyright: © 2019 Journal of Family Medicine and Primary Care

                This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.

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                Categories
                Original Article

                chemoradiation,radical surgery,survival,vulvar cancer
                chemoradiation, radical surgery, survival, vulvar cancer

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