Vulvar cancer in Tunisia: Epidemiological and clinicopathological features multicentric study

Objective To describe for the first time the epidemiologic and clinico-pathologic characteristics of vulvar cancer in Tunisia. Design Two parts are distinguished in this study: Part1: Multicentric retrospective study about the characteristics of all cancer cases diagnosed during a 17-years period (January 1998–December 2014) in three departments of Gynecology and Obstetrics: one in south Tunisia and two in the capital. Part 2: To determine the Incidence trend of invasive vulvar cancer in North Tunisia 1994–2009, on the basis of North Cancer Registry of Tunisia. Results A total of 76 cases of vulvar cancer were recorded. The median age at diagnosis was 65.4 years and 86.9% of patients were more than 55 years old. The symptomatology was dominated by vulvar pruritus in 48.7%. The average size of the tumor was 3.96 cm. Stage III was the most frequent (53.7%) followed by stage II (28.3%). Only 10.4% of tumors were at stage I. The most common histologic type of vulvar malignancy was squamous cell carcinoma (SCC) (94.7%). Standardized incidence varied from 1.2/100 000 (1994) to 0.5/100 000 (2009). There was significant decrease of Standardized incidence (APC of −8.8% per year, 95% CI: −5.5%, −9.0%–p < 0.001). Conclusion Vulvar cancer in Tunisia is a rare disease, occurs mostly in elderly women, and is diagnosed at advanced stages. Our findings emphasize that a greater effort should be made to facilitate early diagnosis, as treatment in earlier stages is less extensive and potentially curative.