Shamini N, Tay E H, Ho T H
Gynaecological Oncology Unit, KK Women's and Children's Hospital, Singapore.
Singapore Med J. 2001 Jul;42(7):292-6.
Vulvar cancer is uncommon in Singapore and to date there have been no local reports on this rare cancer. This is a descriptive study that aims to evaluate our patients' profiles, their management and their outcomes.
Between January 1981 and December 1998, there were 35 patients with vulvar cancer treated at KK Women's and Children's Hospital. The case records of these patients were reviewed. Survival was calculated using the Kaplan-Meier method.
The modal age at diagnosis was 74.0 years (range 17.0-89.0 years). Chinese patients accounted for 88% of the study group, Malays for 6%, Indians for 3% and other races made up 3% of the study group. The most common presenting symptom was an ulcer or lump (83.8%). Squamous cell carcinoma was the most common histological type (80.0%). Vulvar intraepithelial neoplasia III was found in 20% of the cases. There were five patients with other lower genital tract malignancies. Surgery was the most common treatment modality and wound breakdown was the most common complication. The overall five year survival was 75.9%. For stage 1&2 disease, the five year survival was 90.0%. For stage 3&4 disease, the five year survival was 26.0%.
The rarity of vulvar cancer makes it best treated in a tertiary centre. There is a definite survival advantage in early diagnosis and treatment of vulvar cancer. Lymph node surgery was associated with a longer operating time and a higher chance of wound breakdown.
外阴癌在新加坡并不常见，迄今为止尚无关于这种罕见癌症的本地报告。这是一项描述性研究，旨在评估我们患者的概况、治疗方法及治疗结果。
1981年1月至1998年12月期间，新加坡KK妇女儿童医院共收治了35例外阴癌患者。对这些患者的病历进行了回顾。采用Kaplan-Meier方法计算生存率。
诊断时的中位年龄为74.0岁（范围17.0 - 89.0岁）。研究组中，华裔患者占88%，马来裔占6%，印度裔占3%，其他种族占3%。最常见的症状是溃疡或肿块（83.8%）。鳞状细胞癌是最常见的组织学类型（80.0%）。20%的病例中发现了外阴上皮内瘤变III级。有5例患者合并其他下生殖道恶性肿瘤。手术是最常见的治疗方式，伤口裂开是最常见的并发症。总体五年生存率为75.9%。1期和2期疾病的五年生存率为90.0%。3期和4期疾病的五年生存率为26.0%。
外阴癌的罕见性使其最好在三级中心进行治疗。外阴癌的早期诊断和治疗具有明显的生存优势。淋巴结手术与手术时间延长及伤口裂开几率增加有关。
