Demographic, clinical, and treatment trends among women diagnosed with vulvar cancer in the United States

Abstract

Objective-Describe the treatment and survival patterns among a population-based sample of vulvar cancer patients diagnosed in the U.S. in 1999.Methods-Cases were identified for the National Cancer Institute's Patterns of Care Study (POC) using Surveillance, Epidemiology, and End Results Program (SEER). A stratified random sample of non-Hispanic white, non-Hispanic black, and Hispanic women age 20 and older was selected from cases reported by eleven SEER registries. Analyses of the association between vulvar cancer and key demographic, clinical, and hospital characteristics by stage were performed. Cox proportional hazards was used to estimate the odds of death due to cancer. All estimates were weighted, and analyses were conducted with SUDAAN.Results-90% of cases were diagnosed with in situ or early stage invasive disease. Older patients were more likely to present at advanced stages. 25% of women with Stage III-IV vulvar cancer received chemotherapy plus radiation. We noted widespread use of radical local excision among women with Stage I/II cancer, but 46%-54% with invasive disease underwent a radical or total vulvectomy. Factors associated with cancer death were limited to age and stage. Women 75 years and older were at higher risk compared to women aged 20-49 and the risk of death increased with advancing stage.Conclusions-Vulvar cancer is diagnosed at early stages. Late stage disease is associated with a significant increase in mortality. Radical surgery was still commonly performed in 1999. Radiation was more common in women diagnosed at late stage, while the use of chemoradiation remained limited. KeywordsVulva; vulvar; cancer; patterns of care; treatment Correspondence: Antoinette M. Stroup, PhD, Utah Cancer Registry, University of Utah, 650 Komas Drive, Suite 106B, Salt Lake City, Utah 84108, Nan.Stroup@hsc.utah.edu, Tel: (801) 581-8407, Fax: (801) 581-4560. Article Précis Describe treatment and survival among a population-based sample of women in the US diagnosed in 1999 with vulvar cancer and treated in the community.Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers

The Impact of Age on the Prognosis of Vulvar Cancer

“…Furthermore, younger patients in Germany are diagnosed more often with early tumour stages [14]. While other studies have shown that more advanced tumour stages are mainly found in older patients [13,15], this could not be confirmed by the present data. The literature reports contradictory findings on the influence of age on prognosis: While Kumar et al has observed an influence in his SEER data analysis [5], others did not [16].…”

“…However, the present group of patients was clearly different from the SEER patients; the share of patients with LN metastases (21%) and distant metastases (3%) was significantly lower. Furthermore, no differences were found between the groups regarding the tumour stages, whereas the frequency of advanced tumour stages (FIGO III/ IV) varied significantly between the groups in the study by Kumar et al (26% vs. 39%) [5], which, however, was not reproduced in another analysis of the SEER data [15]. …”

Primary Vulvo-Vaginal Cancers: Trends in Incidence and Mortality in Poland (1999-2012)

“…In the United States the highest incidence of vulvar cancer was reported in white women compared to black patients, Hispanic women and Asian/Pacific Islander [20]. Moreover, during the last decade a lack of changes in the age-adjusted incidence and mortality rate of vulvar malignancy was reported in the United States and Germany [6,21,22,23]. These results are in contrast with ours, which show a significant decrease in incidence but an increase in mortality rate.…”

An Integrative Approach Uncovers Biomarkers that Associate with Clinically Relevant Disease Outcomes in Vulvar Carcinoma

“…Vulvar squamous cell carcinoma (VSCC) is an uncommon disease, constituting 3% to 5% of all malignancies in the female genital tract (1,2). VSCC develops primarily in elderly women, after their 70s; however, the number of cases in younger patients has been climbing, likely due to human papillomavirus (HPV) infection (2).…”