Vulval cancer, 1992-2002 audit--multidisciplinary care and prognostic factors.
Vulval carcinoma is becoming increasingly common. Thirty-four cases of vulval carcinoma were treated from 01/01/1992-31/12/2002. The mean age was 67, range (18-90). The presenting complaints were "a lump" (76%)(25/33), "itch" (49%)(16/33), "discomfort" (30%)(10/33) and postmenopausal bleeding (21%)(7/33). Most patients presented with stage 1 or 2 disease (73%) (n = 24/33). The majority (97%) (32/33) underwent surgical treatment. Five-year survival was 61% (17/28), (disease-free survival 76% (13/17)). There were 12 cases of local/regional recurrence. Survival rates deteriorated with stage of disease. Lymph-node results, lowered survival from 79% (11/14), if negative, to 17% (1/6) if positive. Age >70 reduced survival from 69% (11/16) to 50% (6/12). We conclude that age, the stage of disease, and lymph-node status were important prognostic factors. The favourable outcomes reflect muItidisciplinary care--combining clinical examinations with regular home contact with specialist nurses, by telephone.
Mc Millan
H M
HM
Mater Misericordiae Hospital, Eccles Street, Dublin.
Martin
F
F
Walsh
T A
TA
Boyd
W D
WD
Coughlan
B M
BM
D000293:Adolescent; D000328:Adult; D000368:Aged; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007494:Ireland / Q000453:epidemiology; D008207:Lymphatic Metastasis; D008875:Middle Aged; D009367:Neoplasm Staging; D010043:Outcome and Process Assessment, Health Care; D010348:Patient Care Team; D011379:Prognosis; D013997:Time Factors; D014846:Vulvar Neoplasms / Q000453:epidemiology* / Q000401:mortality / Q000473:pathology / Q000628:therapy*