A rare tumour treated primarily by surgery when localised. Management depends on tumour size, location and lymph node involvement.
Vulvar cancer develops in the vulvar region — mainly on the labia majora. In 90% of cases, it is a squamous cell carcinoma of the vulva. Persistent itching, a wound that won't heal, or a change in the appearance of the vulvar skin are the most common warning signs.
Among the risk factors for vulvar cancer: lichen sclerosus, HPV infection (types 16 and 18), smoking, and immunosuppression. The median age at diagnosis is 77 years in France — but this cancer can occur at any age.
Would you like rapid surgical management or a second opinion on your diagnosis or treatment plan?
The histological type — the nature of the cells analysed under the microscope — directly guides treatment and prognosis. In vulvar cancer, squamous cell carcinoma accounts for the vast majority of cases.
Vulvar cancer is often detected at a localised stage precisely because it causes recognisable signs. Consult promptly if you have any of these signs persisting for several weeks.
Do you have any of these signs, particularly persistent itching or a lesion that won't heal? Don't face this uncertainty alone — a consultation will quickly clarify what you are dealing with.
From the first appointment to the end of treatment, here is what happens in practice. Every decision is discussed at a multidisciplinary meeting and with you.
The type of operation depends on tumour size, location, and the multidisciplinary team's decision. Here is what each procedure involves in practice.
What it is. Vulvectomy removes all or part of the vulva depending on tumour extent and lesion location. It may be partial (wide local excision) or total. It is the reference operation for vulvar cancer. The aim is to achieve clear surgical margins.
When it is proposed. In the vast majority of cases of invasive vulvar cancer where surgery is possible. The extent of surgery is adapted to each situation, preserving function and appearance as much as possible.
How it works. The operation lasts 1 to 3 hours depending on associated procedures (with or without inguinal dissection). It is performed under general anaesthesia. Hospitalisation generally lasts 3 to 5 days at Clinique Hartmann.
What about my ovaries? Vulvar surgery does not involve the uterus or ovaries. You will not enter menopause as a result of this operation.
Wound healing. Vulvar wound healing is often difficult and prolonged — 4 to 8 weeks on average, sometimes longer. Healing complications (wound dehiscence, partial necrosis, local infection) are common after vulvectomy. Daily local wound care is required, and home nursing follow-up is systematically arranged on discharge.
What it is for. When cancer spreads, it first passes through the inguinal lymph nodes. The sentinel node is the first lymph node the cancer would reach if it spread. If this node is clear, a complete inguinal dissection is avoided along with its complications.
How it is done. Most commonly using an isotopic technique: a radioactive tracer is injected around the tumour the day before or morning of surgery. This tracer travels to the inguinal sentinel node, detected in the operating theatre using a gamma probe. It is removed for pathological analysis.
If the sentinel node is not identified, a complete inguinal dissection is performed.
What it is. Inguinal dissection involves removing the lymph nodes from the groin — on one or both sides depending on tumour location. These nodes are analysed to determine whether cancer cells have spread.
The main risk. Lymphoedema — leg swelling due to disruption of lymphatic circulation. This risk exists but is limited, especially when the sentinel node technique avoids extensive dissection. Specialist physiotherapy can prevent and treat it.
Radiotherapy may be recommended after surgery in cases of insufficient surgical margins or lymph node involvement. For locally advanced tumours not initially operable, concurrent chemoradiotherapy may be proposed as first-line treatment.
Chemotherapy is less commonly used in vulvar cancer. It is reserved for advanced or metastatic disease, often in combination with radiotherapy.
The decision is made at the MDT after analysis of the surgical specimen, and discussed with you at a dedicated consultation.
A question about the type of operation that applies to you? I explain everything during a consultation.
Surgery is not the end of the journey. Here is what you can concretely expect in the weeks and months that follow.
The most common questions asked in consultation. Ask yours at your appointment.
Vulvar cancer is a rare condition that requires expert surgical management at a centre with specific experience in vulvar surgery. In Paris, Dr Jérémie Zeitoun manages vulvar cancers at Clinique Hartmann (Neuilly-sur-Seine) and consults at 241 rue du Faubourg Saint-Honoré, Paris 8th. Every case is presented at a multidisciplinary meeting before any surgical decision.
Come with your questions, your results, your concerns. We take the time to discuss everything together.
Dr Zeitoun practises as a private specialist (Sector 2) and charges fees above the standard national rate. French national health insurance reimburses on the basis of the standard rate — this is improved for cancer patients (ALD 30). Your complementary health insurance may cover additional fees depending on your policy.