Evaluation of the Clinicopathological Pattern and Treatment Outcome of Vulval Carcinoma at a Tertiary Hospital in Port Harcourt, Nigeria

Abstract

Background : Vulva cancer is a rare but important genital tract malignancy.  Aims: This pioneer study was to determine the prevalence, sociodemographics, clinical présentation, histological pattern and treatment outcome at the University of Port Harcourt Teaching Hospital (UPTH). Materials and Methods: This was a retrospective study of all cases of vulva cancer at the UPTH over a 10-year period from January 1st 2010 to December 31st 2019. Case notes of patients who had vulva cancer were retrospectively reviewed and relevant information were retrieved. Data was analyzed using SPSS version 25 software package. Results: Vulval carcinoma represented 3.6% of all gynaecological cancers. The mean age of patients was 49.7 years, with 41.7% of patients between the ages of 50 to < 65 years. Multiple sexual partners, (50%) and immunosuppression (37.5%) were the most identified risk factors. Vulval pain, vaginal discharge and pruritus vulvae were the major presenting complaints. All the patients had either stage 111 or IV disease at présentation. Excision biopsy (82.6%), partial vulvectomy (60.7%) and total vulvectomy (21.7%) were the commonly performed surgical procedures. Only 17.4% of cases had lymph node dissections. Surgery was mostly complicated by wound  infection (47.6%) and wound breakdown (28.6%). Many (91.7%) of the patients were lost to follow up. Conclusion: Vulva cancer is a rare form of gynaecological cancer. Most patients with vulva cancer presented mainly with pain and pruritus vulvae. Late présentation and advanced-stage disease were the norm in this study. Most patients had inadequate evaluation and surgery due to lack of appropraite skill. There is an urgent need to train specialist in the art of radical vulvectomy.