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Squamous Cell Carcinoma of the Vulva: A Comparison Between Women 35 Years or Younger and 90 Years or Older

Jones, Ian S. ChM, PhD1,2; Crandon, Alex MD, PhD3,4; Sanday, Karen BSc, HIM4

Journal of Lower Genital Tract Disease: July 2013 - Volume 17 - Issue 3 - p 267–272
doi: 10.1097/LGT.0b013e31827527cb
Original Articles

Objective: This study aimed to compare clinical features, diagnosis, management, and outcomes between women 35 years or younger and 90 years or older with vulvar squamous cell carcinoma referred to Queensland Centre for Gynaecological Cancer between 1983 and 2010.

Materials and Methods: Fifty-seven case records, including pathology reports for these 2 groups were reviewed and analyzed using the computer software SPSS 11.0.

Results: Of the cases, 34 were 35 years or younger (mean = 31.6 years), and 23 90 years or older (mean = 92.6 years). International Federation of Gynecology and Obstetrics classification showed grade 1 for 74% in the younger group and 55% for the older group. Patient status showed 22 alive (65%) in the younger group and 4 alive (17%) in the older group. Three younger patients (9%) were dead of disease and 8 (35%) in the older group. Three patients (9%) died of another disease in the younger group and 10 patients (43%) in the older group. Initial treatment was surgical in 30 younger cases (88%) and 18 older cases (78%).

Conclusions: We demonstrated a trend toward younger women presenting with vulvar squamous cell carcinoma and a history of human papillomavirus and vulvar intraepithelial neoplasia. Immune deficiency diseases occurred in 23% of the younger group, but none occurred in the older group, where Alzheimer disease, heart disease, and renal failure (57%) were present. Poorly differentiated tumors and an International Federation of Gynecology and Obstetrics classification of 2 or more resulted in a worse outcome than did better differentiated lesions, irrespective of additional medical conditions.

Poorly differentiated tumors with a FIGO score of 2 or more have a worse outcome, independent of age and additional medical conditions.

From the 1Women’s and Newborn Services, Royal Brisbane and Women’s Hospital, Herston, Queensland; 2Obstetrics and Gynaecology, and 3Gynaecological Oncology, The University of Queensland, Brisbane; and 4Queensland Centre for Gynaecological Cancer, Royal Brisbane and Women’s Hospital, Herston, Queensland, Australia

Reprint requests to: Ian S. Jones, ChM, PhD, Women’s and Newborn Services, Royal Brisbane and Women’s Hospital, Butterfield St, Herston, Q.4029, Australia. E-mail: Ian_Jones@health.qld.gov.au

The authors have declared they have no conflicts of interest.

Copyright © 2013 by the American Society for Colposcopy and Cervical Pathology