title: Vulvar cancer: epidemiology, clinical presentation, and management options.
abstract: BACKGROUND
  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.
  
  
  RESULTS
  Squamous cell carcinoma (SCC) is the most common malignant tumor of the vulva (95%).
  
  
  METHODS
  Pruritus is the most common and long-lasting reported symptom of vulvar cancer, followed by vulvar bleeding, discharge, dysuria, and pain.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Gynecology and Obstetrics, University Hospitals Schleswig-Holstein, Campus Kiel, Kiel, Germany.
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Alkatout
authors.affiliation: Department of Gynecology and Obstetrics, University Hospitals Schleswig-Holstein, Campus Kiel, Kiel, Germany.
authors.forename: Melanie
authors.initials: M
authors.lastname: Schubert
authors.affiliation: Institute for Pathology, University Hospitals Schleswig-Holstein, Campus Kiel, Kiel, Germany.
authors.forename: Nele
authors.initials: N
authors.lastname: Garbrecht
authors.affiliation: Department of Gynecology and Obstetrics, University Hospitals Schleswig-Holstein, Campus Kiel, Kiel, Germany.
authors.forename: Marion Tina
authors.initials: MT
authors.lastname: Weigel
authors.affiliation: Department of Gynecology and Obstetrics, University Hospitals Schleswig-Holstein, Campus Kiel, Kiel, Germany.
authors.forename: Walter
authors.initials: W
authors.lastname: Jonat
authors.affiliation: Department of Gynecology and Obstetrics, University Hospitals Schleswig-Holstein, Campus Kiel, Kiel, Germany.
authors.forename: Christoph
authors.initials: C
authors.lastname: Mundhenke
authors.affiliation: Department of Gynecology and Obstetrics, University Hospitals Schleswig-Holstein, Campus Kiel, Kiel, Germany.
authors.forename: Veronika
authors.initials: V
authors.lastname: Günther
keywords: HPV infection; groin dissection; overall survival; radical vulvectomy; sentinel lymph node biopsy; vulvar cancer
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