Skip to content

    Vulvar Cancer Treatment (PDQ®): Treatment - Health Professional Information [NCI]

    Font Size
    A
    A
    A

    Stage IV Vulvar Cancer

    (Refer to the Treatment Option Overview section of this summary for a more detailed discussion of the roles of surgery, node dissection, radiation therapy, and chemotherapy.)

    Stage IVA

    Recommended Related to Cancer

    General Information About Adult Primary Liver Cancer

    Incidence and Mortality Estimated new cases and deaths from liver and intrahepatic bile duct cancer in the United States in 2014:[1] New cases: 33,190. Deaths: 23,000. Hepatocellular carcinoma (HCC) is relatively uncommon in the United States, although its incidence is rising, principally in relation to the spread of hepatitis C virus (HCV) infection.[2] HCC is the most common solid tumor worldwide and the third leading cause of cancer-related deaths.[3,4] Both local extension...

    Read the General Information About Adult Primary Liver Cancer article > >

    Standard treatment options:

    1. Radical vulvectomy and pelvic exenteration.
    2. Surgery followed by radiation therapy for large resected lesions with narrow margins. Localized adjuvant radiation therapy consisting of 45 Gy to 50 Gy may also be indicated when there is capillary-lymphatic space invasion and thickness greater than 5 mm.[1] Radiation therapy to the pelvis and groin is given if two or more groin nodes are involved.[2,3]
    3. Neoadjuvant radiation therapy or chemoradiation of large primary lesions to improve operability, followed by radical surgery.[4,5,6,7,8,9,10]
    4. For those patients unable to tolerate radical vulvectomy or who are deemed unsuitable for surgery because of site or extent of disease, radical radiation therapy may be associated with long-term survival.[11,12] When radiation therapy is used for primary definitive treatment of vulvar cancer, some physicians prefer to add concurrent 5-FU or 5-FU and cisplatin.[1,13,14,15,16,17]

    Stage IVB

    There is no standard treatment approach in the management of metastatic vulvar cancer. Local therapy must be individualized depending on the extent of local and metastatic disease. There is no standard chemotherapy for metastatic disease, and reports describing the use of this modality are anecdotal.[17] However, by largely extrapolating from regimens used for anal or cervical cancer, chemotherapy has been studied. Regimens have included various combinations of 5-fluorouracil, cisplatin, mitomycin-C, or bleomycin.[6,17,18] Given the advanced age and comorbidity of many patients with advanced or recurrent vulvar cancer, patient tolerance is a major consideration in the use of these agents. Physicians should offer eligible patients participation in clinical trials.

    Information about ongoing clinical trials is available from the NCI Web site

    Current Clinical Trials

    Check for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with stage IVA vulvar cancer and stage IVB vulvar cancer. The list of clinical trials can be further narrowed by location, drug, intervention, and other criteria.

    1 | 2

    WebMD Public Information from the National Cancer Institute

    Last Updated: May 28, 2015
    This information is not intended to replace the advice of a doctor. Healthwise disclaims any liability for the decisions you make based on this information.
    Next Article:

    Hot Topics

    WebMD Video: Now Playing

    Click here to wach video: Dirty Truth About Hand Washing

    Which sex is the worst about washing up? Why is it so important? We’ve got the dirty truth on how and when to wash your hands.

    Click here to watch video: Dirty Truth About Hand Washing

    Popular Slideshows & Tools on WebMD

    disciplining a boy
    Types, symptoms, causes.
    fruit drinks
    Eat these to think better.
    embarrassed woman
    Do you feel guilty after eating?
    diabetes highlighted
    4 early warning signs.
    handful of vegetables and vitamins
    Diet tips and mistakes.
    birth control pills
    Which kind is right for you?
    Remember your finger
    Are you getting more forgetful?
    sticky notes on face
    10 tips to clear your brain fog.
    Close up of eye
    12 reasons you're distracted.
    Trainer demonstrating exercise for RA
    Exercises for your joints.
    apple slices with peanut butter
    What goes best with workouts?
    woman having a good day
    Revitalize your life.

    Women's Health Newsletter

    Find out what women really need.