Objective This study evaluated the risk factors, clinical presentation and different modalities of treatment and survival outcome of vulvar cancer patients.

Methods Method: This was a cohort study of 76 cases diagnosed as vulvar cancer in National Institute of Cancer Research & Hospital from July 2015 to June 2020. Risk factors, stage of disease, treatment modalities, disease outcomes and survival were analyzed. Kaplan-Meier curve was used to determine the predictors for progression free survival and overall survival.

Results Mean age of the patients was 54.5 years and 52.6% patients were below 40 years. The percentages of the patients with FIGO stage I, II, III and IV were 14.5%, 34.2%, 28.9%, and 7.9% respectively. About 68% had positive inguinal nodes and 20 (26.3%) were HPV positive. Squamous cell carcinoma (81.6%) was the predominant type. Equal number of patients (21, 27.6%) were treated by Wide Local Excision with Bilateral Groin Node Dissection (BGND) and by Radical Vulvectomy with BGND, 11 (14.5%) received CCRT. Forty-four patients (57.9%) were in irregular follow up. About 13% patients experienced local recurrence, 35 (46.1%) cured, 12 (15.8%) expired, 18 (23.7%) were alive with disease & rest were lost to follow up. Overall survival was 77.1 months. At the end of the five year 63.6, 38.2 and 9.09 percents of patients of Stage I, II and III were alive respectively.

Conclusion/Implications Vulvar cancer can occur below 40 years of age. Surgical treatment is the best option in the early stage of disease (Stage I and II) and gives high survival rates.