Prognosis and survival for vulvar cancer

If you have vulvar cancer, you may have questions about your prognosis. A prognosis is the doctor’s best estimate of how cancer will affect someone and how it will respond to treatment. Prognosis and survival depend on many factors. Only a doctor familiar with your medical history, the type and stage and other features of the cancer, the treatments chosen and the response to treatment can put all of this information together with survival statistics to arrive at a prognosis.

A prognostic factor is an aspect of the cancer or a characteristic of the person that the doctor will consider when making a prognosis. A predictive factor influences how a cancer will respond to a certain treatment. Prognostic and predictive factors are often discussed together. They both play a part in deciding on a treatment plan and a prognosis.

The following are prognostic and predictive factors for vulvar cancer.

Spread to the lymph nodes

The most important prognostic factor for vulvar cancer is the number of lymph nodes in the groin (inguinal nodes) that the cancer has spread to. Vulvar cancer that has not spread to any lymph nodes has the best prognosis.

Vulvar cancer that has spread to lymph nodes on both sides of the groin has a poorer prognosis than vulvar cancer that has spread only to lymph nodes on the same side of the groin as the tumour.

Stage

The stage is an important prognostic factor for most types of vulvar cancer. Women diagnosed with early stage vulvar cancer have a better prognosis than women diagnosed with cancer at a later stage.

Tumour diameter

Vulvar tumours that are 2 cm or smaller have a better prognosis than tumours that are larger than 2 cm.

Depth of tumour growth

Tumours that have grown deeper into the tissue of the vulva have a poor prognosis. The deeper the tumour has grown into the tissue, the poorer the prognosis.

Local spread

Local spread is how far the tumour has grown beyond the groin and into the surrounding tissues. The farther the tumour has spread, the poorer the prognosis.

Type of tumour

Some types of vulvar cancer have a better prognosis than others. For example, verrucous carcinoma of the vulva has a good prognosis as it usually doesn’t spread. Melanoma of the vulva has a poorer prognosis than other types of vulvar tumours because of the high rate of cancer coming back and spreading to other organs.

Time of recurrence

Vulvar cancer that comes back (recurs) more than 2 years after the initial treatment has a better prognosis than vulvar cancer that comes back sooner.

Expert review and references

  • American Cancer Society. Vulvar Cancer. 2014. https://www.cancer.org/cancer/vulvar-cancer.html.
  • Brierley JD, Gospodarowicz MK, Wittekind C (eds.). TNM Classification of Malignant Tumours. 8th ed. Wiley Blackwell; 2017.
  • Klopp AH, Eifel PJ, Berek JS, Konstantinopoulos PA. Cancer of the cervix, vagina and vulva. DeVita VT Jr, Lawrence TS, Rosenberg SA. Cancer: Principles and Practice of Oncology. 10th ed. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins; 2015: 72:1013-1047.
  • Levine DA, Dizon DS, Yashar CM, Barakat RR, Berchuch A, Markman M, Randall ME. Handbook for Principles and Practice of Gynecologic Oncology. 2nd ed. Philadelphia, PA: Wolters Kluwer; 2015.

Survival statistics for vulvar cancer

Survival statistics for vulvar cancer are very general estimates and must be interpreted very carefully. Because these statistics are based on the experience of groups of people, they cannot be used to predict a particular woman’s chances of survival.

Medical disclaimer

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