Simple vulvectomy gives a 5-year survival rate of essentially 100% but is seldom indicated. Other more limited surgical procedures produce equivalent results and are less deforming. The choice of treatment depends on the extent of the disease.
Vulvar intraepithelial neoplasia (VIN) occupying nonhairy areas can be considered an epithelial disease; however, VIN occupying hairy sites usually involves the pilosebaceous apparatus and requires a greater depth of destruction or excision. Whatever procedure is used, a significant number of patients develop a recurrence with the most common sites being the perianal skin, presacral area, and clitoral hood. The use of topical fluorouracil is not a reliable first choice for treatment.
Cancer of the colon is a highly treatable and often curable disease when localized to the bowel. Surgery is the primary form of treatment and results in cure in approximately 50% of the patients. Recurrence following surgery is a major problem and is often the ultimate cause of death.
Incidence and Mortality
Note: Estimated new cases and deaths from colon cancer in the United States in 2013:
New cases: 102,480 (colon cancer only).
Deaths: 50,830 (colon and rectal cancers combined)...
Wide local excision or laser beam therapy or a combination of both.
Skinning vulvectomy with or without grafting.
Use of 5% fluorouracil cream (response rate of 50%-60%).
Current Clinical Trials
Check for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with stage 0 vulvar cancer. The list of clinical trials can be further narrowed by location, drug, intervention, and other criteria.
General information about clinical trials is also available from the NCI Web site.
Wright VC, Chapman W: Intraepithelial neoplasia of the lower female genital tract: etiology, investigation, and management. Semin Surg Oncol 8 (4): 180-90, 1992 Jul-Aug.
Di Saia PJ, Rich WM: Surgical approach to multifocal carcinoma in situ of the vulva. Am J Obstet Gynecol 140 (2): 136-45, 1981.
Woodruff JD, Julian C, Puray T, et al.: The contemporary challenge of carcinoma in situ of the vulva. Am J Obstet Gynecol 115 (5): 677-86, 1973.