Diagnosis and management of vulvar cancer: A review

Tan, Andrea; Bieber, Amy Kalowitz; Stein, Jennifer A.; Pomeranz, Miriam Keltz

doi:10.1016/j.jaad.2019.07.055

Cited by 58 publications

(74 citation statements)

References 99 publications

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“…As we discovered in this study, the vulvar SCC incidence rates have been increasing, supporting previous observations evaluating vulvar SCC incidence in the United States (15,16), consistent with the ndings of previous studies suggesting increasing vulvar cancer incidence rates in Norway, Germany, and…”

Section: Discussionsupporting

confidence: 93%

Rising and Falling Trends in Incidence Rates of Vulvar and Vaginal Cancers in the United States, 2000-2016

Yue

Zhou

Pei

2020

Preprint

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Background: Few studies focus on incidence trends in vulvar and vaginal by histological type, race, age, and region. We aimed to evaluate the temporal incidence trends and survival for the two cancers.Methods: Cases with primary vulvar or vaginal carcinoma from 2000-2016 were identified from the Surveillance, Epidemiology, and End Results 18 registries. Annual percent change (APC) and average APC (AAPC) were calculated to evaluated trends. Relative survival was estimated to compare survival outcomes.Results: Vulvar cancer incidence rates were highest among non-Hispanic whites (20.9 per 1,000,000 person-years) and in the Midwest (27.7), while vaginal cancer rates were highest among non-Hispanic blacks (8.2) and in the South (6.7). Overall, vulvar cancer rate increased 0.4% annually (AAPC, 0.4%; 95% CI, 0.1% to 0.6%), but vaginal cancer rate decreased 1.4% annually (AAPC, -1.4%; 95% CI, -2.0% to -0.5%). The increased vulvar cancer rate was only observed for squamous cell carcinoma (APC, 1.0%), while the decreased vaginal cancer rate was only observed for other malignancies (APC, -1.7%). Vulvar cancer rates increased only among whites (APC, 1.2%), but vaginal cancer rates decreased only among whites (AAPC, -1.3%) and Asians (APC, -2.7%). Vulvar cancer rates increased among patients aged 50-59 (APC, 1.1%), 60-69 (APC, 1.3%), and 70-79 (APC, 1.2%) years, while vaginal cancer rates decreased among patients aged 50-59 (APC, -1.4%) and 80 (APC, -1.4%) years or older. Overall, whites had the highest five-year relative survival for both vulvar (72.22%) and vaginal (49.03%) cancers. Conclusion: There were profound disparities in vulvar and vaginal cancer incidence rates attributable to histological type, race, age, and region. The increased vulvar cancer rates and the declined vaginal cancer rate highlights the importance of further studies to investigate the reason for the disparities.

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Section: Discussionsupporting

confidence: 93%

Rising and Falling Trends in Incidence Rates of Vulvar and Vaginal Cancers in the United States, 2000-2016

Yue

Zhou

Pei

2020

Preprint

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“…Currently, local surgery is preferred, but the application of inguinal lymph node dissection and sentinel lymph node biopsy remains controversial. Therefore, surgical treatment tends to be conservative, and extensive local excision is advocated 4 6 . Radiation therapy is often used after surgical resection for patients with locally or regionally advanced melanoma and for those with unresectable distant metastases, and it can help in the palliation of metastatic melanoma 7 .…”

Section: Discussionmentioning

confidence: 99%

A successfully treated malignant melanoma arising in a large congenital vulvar blue nevus

Lin

Song

Ran

et al. 2020

Dermatologic Therapy

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“…Other risk factors are immunosuppression (decreased immune system), smoking, and history of cervical cancer. Vulvar cancer is treated individually by surgery, chemotherapy, radiation therapy, or a combination of these (41,42).…”

Section: Vulvar Cancermentioning

confidence: 99%

Incontinence, physical activity, and pelvic floor muscle training in female pelvic cancer survivors after radiotherapy

Lindgren

2020

Linköping University Medical Dissertations

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Background: Cancer treatment continues to improve, contributing to an evergrowing population of cancer survivors. Pelvic cancer survivors (PCS) constitute the second largest group of female cancer survivors after breast cancer. Many female PCS have been treated with radiotherapy as a part of their cancer treatment. Unfortunately, like all effective cancer treatments, pelvic radiotherapy is associated with a risk of subsequent, unwanted side effects. Some side effects remain or persist long after the end of treatment and some are even lifelong. A common and burdensome side effect after pelvic radiotherapy is urinary and/or fecal incontinence. Incontinence is known to negatively affect quality of life (QoL) and physical activity levels. Physical activity contributes to several positive health effects. In cancer survivors, it may reduce the risk of recurrence and even the mortality risk. Cancer survivors in general, and female PCS in particular, tend to be less physically active after cancer treatment than before treatment. When suffering from urinary and even fecal incontinence, pelvic floor muscle training (PFMT) is recommended as a first-line treatment for the general population. In addition to decreased incontinence levels, PFMT may contribute to increased physical activity and better QoL. However, little attention is given to PFMT as a potential treatment for incontinence in the Swedish national care program for pelvic cancer rehabilitation. Furthermore, there is as yet no evidence that PFMT is as effective in female PCS as in female non-cancer survivors. The effectiveness of PFMT cannot be taken for granted because female PCS survivors often have treatment-induced damage to structures in the pelvic floor that might affect its applicability. However, the problem of incontinence among female PCS remains, along with the fact that they tend to be less physically active than other cancer survivors. Indeed, this is an important research area and a necessary problem for health-care providers to resolve, not least for physiotherapists. Aim: The overall aim of this thesis is to improve the understanding of female PCS' experiences of incontinence in relation to physical activity, QoL, and rehabilitative efforts, including PFMT. This includes gaining increased knowledge about the relation between incontinence and physical activity in the form of exercise and QoL, and whether PCS experience that physiotherapy contributes in a valuable way to reducing their incontinence. This could enable the development of meaningful physiotherapeutic interventions, that PCS can and are willing to engage in, to achieve a potential reduction in incontinence, as well as increased QoL and activity levels. Methods: The thesis includes four different studies, using three different methods, all conducted with female PCS. Studies I (n=13) and IV (n=11) are qualitative individual interview studies, using semi-structured interview guides. Study II is a cohort-based cross-sectional observational study (n=578) and Study III is a prospective cohort-b...

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Diagnosis and management of vulvar cancer: A review

Cited by 58 publications

References 99 publications

Rising and Falling Trends in Incidence Rates of Vulvar and Vaginal Cancers in the United States, 2000-2016

Rising and Falling Trends in Incidence Rates of Vulvar and Vaginal Cancers in the United States, 2000-2016

A successfully treated malignant melanoma arising in a large congenital vulvar blue nevus

Incontinence, physical activity, and pelvic floor muscle training in female pelvic cancer survivors after radiotherapy

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