Vulvar cancer is not a disease of the elderly: Treatment and outcome at a tertiary referral centre in South Africa
| Autor: | J L Butt, M H Botha |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
Gynecology
lcsh:R5-920 medicine.medical_specialty 030219 obstetrics & reproductive medicine business.industry Tertiary referral centre lcsh:R lcsh:Medicine Retrospective cohort study General Medicine Disease Vulvar cancer medicine.disease female genital diseases and pregnancy complications Koilocyte 03 medical and health sciences 0302 clinical medicine Abnormal PAP Smear Survival probability 030220 oncology & carcinogenesis Internal medicine medicine Human papillomavirus lcsh:Medicine (General) business |
| Zdroj: | South African Medical Journal; Vol 107, No 11 (2017); 1000-1004 SAMJ: South African Medical Journal, Volume: 107, Issue: 11, Pages: 1000-1004, Published: NOV 2017 South African Medical Journal, Vol 107, Iss 11, Pp 1000-1004 (2017) |
| ISSN: | 2078-5135 0256-9574 |
| Popis: | Background. An increase in vulvar cancer in young women is attributed to infection with oncogenic human papillomavirus (HPV). South Africa (SA) has a high prevalence of HPV, and it was therefore hypothesised that women with vulvar cancer here would be younger than in high-income countries (HICs). Objective. To describe age, cancer stage, treatment and outcome of patients with vulvar cancer at a tertiary referral centre in SA. Methods. In a retrospective observational study, patient records of women diagnosed with vulvar cancer between 2001 and 2014 were reviewed and demographic and surgical details captured. Histology results of vulvar biopsies and resected specimens were checked for HPV changes, koilocytes and usual-type vulval intraepithelial neoplasia. Patients were restaged using the International Federation of Gynecology and Obstetrics (FIGO) 2009 staging system to allow for comparison of outcomes. Five-year disease-specific survival probability curves were generated using Kaplan-Meier analysis. Results. The mean age of the 180 patients in the study was 52.5 years. Those who had documented HPV changes on histological specimens had a mean age of 50.4 years. More than 50% of the patients had advanced-stage disease, and 62.7% were treated with primary surgery. Five-year disease-specific survival probabilities were similar to those reported in the literature. Conclusions. Vulvar cancer should not be regarded as a disease of the elderly in SA, as women with vulvar cancer are 10 - 15 years younger than in HICs. A large proportion of patients present with advanced-stage disease. Health professionals should be alert to vulvar lesions, especially in women with abnormal Pap smears, to reduce the morbidity and mortality of this disease. |
| Databáze: | OpenAIRE |
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