Ten years' experience in the treatment of vulvar cancer at the National Institute of Oncology and Radiobiology
Abstract
Introduction: Vulvar cancer is an uncommon condition. In recent years its incidence has risen in patients aged under 50 years, associated to an increase in vulvar intraepithelial neoplasia.
Objective: Describe the clinical characteristics and the treatment of vulvar cancer patients attending the National Institute of Oncology and Radiobiology in a ten years' period.
Methods: A retrospective review was conducted of 200 patients diagnosed with and treated for vulvar cancer from January 2008 to December 2018. The variables studied were age, clinical stage, histological type, a history of VIN, human papillomavirus and overall survival.
Results: A predominance was found of patients aged over 55 years (67.5%). 55.0% of the patients were diagnosed during stage I. Epidermoid carcinoma was the most common histological type (88.5%). An association was found between the presence of papillomavirus and age under 55 years (p < 0.001), as well as a relationship between premalignant lesions and that age group (p = 0.029). 44.4% of the patients with premalignant lesions had papillomavirus infection. The surgical procedure most commonly applied was radical vulvectomy (45.4%). Overall survival was 50.4% at 5 years.
Conclusions: Despite its low frequency, the incidence of vulvar carcinoma has increased at the Institute of Oncology. Early detection should be implemented to achieve a better prognosis of this disease.
Key words: vulvar cancer; HPV; vulvectomy.Downloads
References
Howlader N, Noone AM, Krapcho M, et al, editors. SEER CancerStatisticsReview, 1975–2014. Bethesda, MD: National Cancer Institute.Vulvar Cancer. Bethesda, MD: NationalCancerInstitute. [Internet] 2013 [citado 14 de marzo de 2021] Disponible en: http://seer.cancer.gov/statfacts/html/vulva.html.
Clancy AA, Spaans JN, Weberpals JI. The forgotten woman’s cancer: vulvar
squamous cell carcinoma (VSCC) and a targeted approach to therapy. Annals of
Oncology 2016; 27: 1696–1705. doi:10.1093/annonc/mdw242
Muigai J, Jacob L, Dinas K, Kostev K, Kalder M. Potential delay in the diagnosis of
vulvar cancer and associated risk factors in women treated in German gynecological
practices. Oncotarget 2018; 9:8725–8730.
Xiao X, Meng YB, Bai P, et al. Vulvar cancer in China: Epidemiological features and risk
analysis. J Cancer 2017; 8:2950–2958.
Klopp A H, Eifel PJ, Berek JS, Konstantinopoulos P A: Cancer of the cervix, vagina,
and vulva: DeVita VT Jr, Lawrence TS, Rosenberg SA: Cancer: Principles and
Practice of Oncology. 10th ed. Philadelphia, Pa: Lippincott Williams & Wilkins, 2015,
pp. 1013-47.
Faber MT, Sand FL, Albieri V, Norrild B, Kjaer SK, Verdoodt F. Prevalence and
type distribution of human papillomavirus in squamous cell carcinoma and intraepithelial
neoplasia of vulva. Int J cancer 2017; 141:1161-1169. Disponible en:
https:/www.ncbi.nlm.nih.gov/pubmed/28577297
Rogers LJ, Cuello MA. Cancer of the vulva. FIGO CANCER REPORT 2 0 1 8. Int J
GynecolObstet 2018; 143 (Suppl. 2): 4–13. DOI: 10.1002/ijgo.12609
Hacker NF. Revised FIGO staging for carcinoma of the vulva. Int J GynecolObstet
2009;105:105–106.
Koh WJ, Greer BE, Abu-Rustum NR, et al. Vulvar cancer, version 1.2017, NCCN clinical
practice guidelines in oncology. J Natl ComprCancNetw 2017; 15:92–120.
Dahbi Z, Elmejjatti F, Naciri F, Guerouaz A, Oabdelmoumen A, Sbai A, et al. Vulvar cancer
treatment options: experience in the Oncology Center in Oujda].PanAfr Med J [Internet] 2018
[citado 14 de marzo de 2021]; 31:182. doi: 10.11604/pamj.2018.31.182.13812. eCollection 2018.
de Martel C, Ferlay J, Franceschi S, et al. Global burden of cancers attributable to infections in
2008: a review and synthetic analysis. Lancet Oncol 2012;13(6):607–615.
Jones GL, Jacques RM, Thompson J, Wood HJ, Hughes J, Ledger W, et al. The impact of
surgery for vulval cancer upon health-related quality of life and pelvic floor outcomes during
the first year of treatment: a longitudinal, mixed methods study. Psychooncology. 2016;
25(6):656-62. doi: 10.1002/pon.3992. Epub 2015 Sep 25.
Kroeber ES, Mathewos A, Wondemagegnehu T, Aynalem A, Gemechu T, Piszczan S, et al.
Vulvar cancer in Ethiopia: A cohort study on the characteristics and survival of 86 patients.
Medicine (Baltimore). 2018 Mar; 97(9):e0041. doi: 10.1097/MD.0000000000010041.
Singh N, Negi N, Srivastava K, Agarwal G. A cohort study of vulvarcancer over a period of 10
years and review of literature. Indian J Cancer 2016;53(3):412–415.
Torres-Lobatón A, Vázquez-Tinajero A, Jiménez-Arroyo EP, Barra-Martínez R, Oliva-Posada
JC, Morgan-Ortiz F. Cáncer de vulva. Repercusiones del tratamiento quirúrgico: experiencia
con 151 pacientes. GynecolObstetMex 2018; 86(7):423-433. Disponible en:
https://doi.org/10.24245/gom. v86i7.2187
Figge DC. Rare Vulvar Malignancies. Greer Be, Berek JS, eds. Current Topics In Obstetric
and Gynecology: Gynecologic Oncology: Treatment Rationale and Techniques: Elsevier; 1991:
239-257.
Allbritton JI. Vulvar neoplasms, benign and malignant. ObstetGynecolClin North Am. 2017;
44:339–352.
AEPCC-Guía: Neoplasia vulvarintraepitelial (VIN). Coordinadora: Ramírez, M. Autores: Andía,
D., Bosch, J.M., Cararach, M., Coronado, P., de Sanjosé, S., López, J.A., Martínez J.C., Puig-
Tintoré, L.M., Vidart, J.A. Revisores-editores: del Pino M., Torné, A. Publicaciones AEPCC. 2015;
39p.
Mitra S, Sharma MK, KaurI, Khurana R, Modi KB, Narang R, et al. Vulvar carcinoma: dilemma,
debates, and decisions. Cancer Manag Res2018; (10): 61–68.
Wagner M, Bennet SL, Patel H, WelnerS, Sanjose S, Weiss TW. Global availability of data on
HPV genotype – distribution in cervical, vulvar and vaginal disease and genotype-specific
prevalence and incidence of HPV infection in females. Infect Agent Cancer 2015; 10:
13(doi:10.1186/513027-015-0008-y)
Munger K, Baldwin A, Edwards KM, HayakawaH, NguyenCL, OwensM, et al. Mechanisms of
human papillomavirus-induced oncogenesis. J Virol 2004; 78(21): 11451-11460.
Jeevarajan S, Duraipandian A, KottayasamySeenivasagam R, Shanmugam S, Ramamurthy
R. Treatment Outcome of Carcinoma Vulva Ten-Year Experience from a Tertiary Cancer
Centre in South India. Int J SurgOncol 2017; 2017:7161437. doi: 10.1155/2017/7161437.
Epub 2017 Dec 14.
Shylasree TS, Bryant A, Howells RE: Chemoradiation for advanced primary vulval cancer. Cochrane DatabaseSystRev (4): CD003752, 2011.
Palumbo AR, Fasolino C, Santoro G, et al. Evaluation of symptomsand prevention of cancer in
menopause: the value of vulvar exam. Transl Med UniSa2016;15:74–9.
Hansen BT, Campbell S, Nygard M. Long-term incidencetrends of HPV-related cancers, and
cases preventable by HPVvaccination: a registry-based study in Norway. BMJ Open 2018;
8:e019005.
Allbritton JI. Vulvar neoplasms, benign and malignant. ObstetGynecolClin North Am. 2017;
44:339–52.
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