Management and outcomes for elderly women with vulvar cancer over time

Abstract

Methods Women were stratified by age: <50, 50-64, 65-79, and ≥80 years. Differences in survival and treatment patterns were analysed between age groups. Multivariate logistic regression models were constructed to examine treatment patterns. KaplanMeier and Cox proportional hazards survival methods were used to assess survival.Main outcome measures Vital status from the date of diagnosis until death, censoring or last follow-up. ResultsThe final study group consisted of 8553 women, 1806 (21.12%) <50 years, 2141 (25.03%) 50-64 years, 2585 (30.22%) 65-79 years, and 2021 (23.63%) >80 years old. After adjusting for patient and tumour characteristics, older women were less likely to have surgery and more likely to receive radiotherapy. Compared with women under 50 years, women 50-64 had a two-fold higher risk of death (HR 1.91, 95% CI 1.55-2.34); those 65-79 years had a four-fold higher risk of death (HR 4.01,, and those ≥80 years had a seven-fold higher risk of death (HR 6.98,). These trends stayed relatively constant over the time periods studied.Conclusions Women over 50 years are at a higher risk of vulvar cancer-specific mortality, which increases with age. These trends stayed relatively constant over the time periods studied.

Palliative electro‐chemotherapy in elderly patients with vulvar cancer: A phase II trial

“…Severe pain affects daily activities such as walking, sitting, urinating and sleeping . Age, comorbidity, natural history, and previous treatment of cancer limit the feasibility of therapies such as chemotherapy and radiotherapy .…”

Tumoral PD-L1 expression defines a subgroup of poor-prognosis vulvar carcinomas with non-viral etiology

“…Approximately 65% of VSCCs are HPV-positive and the oncogenic high-risk types HPV-16/-18/-31/-33 are most frequently detected [ 6 ]. However, the burden of VSCC still lies with older women, in whom survival rates are low due to more aggressive tumors, diagnosis at later stages and frequent under-treatment [ 7 , 8 ]. Surgery - consisting of local tumor excision with sentinel or inguinofemoral lymph node dissection - is considered the cornerstone of therapy.…”

Predictors and Patterns of Local, Regional, and Distant Failure in Squamous Cell Carcinoma of the Vulva

“…1 Squamous cell carcinoma is the most prevalent subtype. 1,2 Traditionally, curative treatment of squamous cell VC includes radical vulvectomy plus (superficial and deep) inguinal-femoral lymphadenectomy. 3 However, growing evidence suggested that less invasive procedures (ie, simple vulvectomy, wide local excision, sentinel node biopsy) provide similar long-term results, minimizing morbidity.…”