Hampl Monika, Deckers-Figiel Stella, Hampl Juergen A, Rein Daniel, Bender Hans G
Department of Obstetrics and Gynecology, Heinrich Heine University, Duesseldorf, Germany.
Gynecol Oncol. 2008 Jun;109(3):340-5. doi: 10.1016/j.ygyno.2008.01.041. Epub 2008 Apr 14.
To characterize the changes in incidence, age of disease onset, tumor site and patients characteristics in women with invasive vulvar cancer in a German University Hospital unit over a 28-year period.
The clinical records for women treated for invasive vulvar cancer from 01/1980 until 06/2007 were analyzed. We performed a retrospective analysis for three 9-year periods: 1/1980 to 02/1989; 3/1989 to 04/1998 and 05/1998 to 06/2007. For each cohort, the number of cases treated, age of disease onset, tumor site and further characteristics were extracted and statistically evaluated.
A total of 224 patients with vulvar cancer were identified between 1/1980 and 6/2007. The number and mean age changed significantly over time: between 1/1980 and 02/1989 53 women with a mean age of 65.6 years were treated for invasive vulvar cancer, between 03/1989 and 04/1998 this number increased to 69 women with a mean age of 63.9 years and in the last period, 102 women with a mean age of 57.0 years were treated for vulvar cancer. The total increase was 192%. In the first period 11% of the women were aged 50 years or less compared with over 41% in the third period (p=0.001). Two-third of the tumors women aged<50 years were HPV-positive. Significant changes in the tumor site were observed; from labial position to the region between clitoris and urethra: 37% in the last period compared with 19% in the first period (p>0.05).
Although in the literature the incidence of invasive cancer has been reported to be stable or only minimally increased, the results of this study show that the number of patients presenting with invasive vulvar cancer has doubled within the last three decades at one university hospital unit in Germany, with a nearly 4-time increase in younger patients (+372%) due to HPV high risk infection. The tumor localization changed significantly from the labia to the area between the clitoris and urethra. Assuming that these limited data reflect the general trend in the incidence of HPV-induced vulvar cancer, widely-implemented prophylactic quadrivalent HPV vaccination, which has been proven to be highly effective against anogenital disease, could make an important contribution to the reduction of the risk of vulvar carcinomas in younger women.
描述德国一家大学医院科室28年间浸润性外阴癌女性患者的发病率、发病年龄、肿瘤部位及患者特征的变化情况。
分析1980年1月至2007年6月间接受浸润性外阴癌治疗的女性患者的临床记录。我们对三个9年时间段进行了回顾性分析：1980年1月至1989年2月；1989年3月至1998年4月；1998年5月至2007年6月。对于每个队列，提取治疗病例数、发病年龄、肿瘤部位及其他特征，并进行统计学评估。
1980年1月至2007年6月间共确诊224例外阴癌患者。病例数和平均年龄随时间有显著变化：1980年1月至1989年2月，53例浸润性外阴癌患者接受治疗，平均年龄65.6岁；1989年3月至1998年4月，这一数字增至69例，平均年龄63.9岁；在最后一个时间段，102例平均年龄57.0岁的女性接受了外阴癌治疗。总数增长了192%。第一阶段1
