Sajo Adekunle Emmanuel, Mnisi Edwin Francis, Bassa Sheynaz, Visser Cathy, Dreyer Greta
Department of Obstetrics and Gynaecology, Gynaecologic Oncology Unit, University of Pretoria, Pretoria, South Africa.
Department of Obstetrics and Gynaecology, Kalafong Provincial Tertiary Hospital, Pretoria, South Africa.
PLoS One. 2025 Jul 1;20(7):e0327119. doi: 10.1371/journal.pone.0327119. eCollection 2025.
The main objective of this study was to describe the clinical, pathological and treatment characteristics of patients with vulvar cancer who had surgery and or radiotherapy at Steve Biko Academic Hospital. The absolute and relative disease burden, trends over the time period were also analyzed.
This was a retrospective study that described women with vulvar cancer who presented to the Gynaecology Oncology and Radiation Oncology departments of the hospital between January 2012 and December 2022. Their clinical, pathology and radiotherapy treatment records were reviewed for this study.
317 vulvar cancer cases between 2012 and 2022 were included in the analysis. The average age was 45.1±12.7. Forty percent of the participants were younger than 40 years. More than 75% of them were women living with HIV and were all on antiretroviral treatment. The average age of those who were HIV positive was 20 years lower than their HIV negative counterparts, p <0.0001. Their mean haemoglobin (Hb) at presentation was 10.7g/dL. Squamous cell carcinoma was the most common histological type in 96.5% of cases. Sixty four percent of the cases presented in advanced stage. About 48% of those who had primary radiation received curative doses. The median time to completion of radiotherapy treatment was higher among those who received primary radiotherapy as compared to those who received adjuvant treatment, 51.5 vs 46 days, p 0.039. The annual average age decreased from 56 years to as low as 40 years, a mean difference of 16 years, p 0.012.
It is striking that vulvar cancer is no longer a disease of elderly women. Its incidence is now high among women below 50 years. The study also showed an upward trend in the number of vulvar cancer cases in contrast to the declining average age at diagnosis. There is need for more vulvo-perineal surveillance of HIV positive women to detect early stage of vulvar cancers.
本研究的主要目的是描述在史蒂夫·比科学术医院接受手术和/或放疗的外阴癌患者的临床、病理和治疗特征。还分析了绝对和相对疾病负担以及该时间段内的趋势。
这是一项回顾性研究，描述了2012年1月至2022年12月期间到该医院妇科肿瘤学和放射肿瘤学科室就诊的外阴癌女性患者。本研究对她们的临床、病理和放疗治疗记录进行了回顾。
分析纳入了2012年至2022年期间的317例外阴癌病例。平均年龄为45.1±12.7岁。40%的参与者年龄小于40岁。超过75%的患者为感染艾滋病毒的女性，且均接受抗逆转录病毒治疗。艾滋病毒呈阳性者的平均年龄比艾滋病毒呈阴性者低20岁，p<0.0001。她们就诊时的平均血红蛋白（Hb）为10.7g/dL。鳞状细胞癌是最常见的组织学类型，占96.5%的病例。64%的病例为晚期。接受原发性放疗的患者中约48%接受了根治性剂量。与接受辅助治疗的患者相比，接受原发性放疗的患者完成放疗治疗的中位时间更长，分别为51.5天和46天，p=0.039。年平均年龄从56岁降至低至40岁，平均差异为16岁，p=0.012。
令人惊讶的是，外阴癌不再是老年女性的疾病。现在50岁以下女性中的发病率很高。该研究还显示，外阴癌病例数量呈上升趋势，而诊断时的平均年龄却在下降。需要对艾滋病毒呈阳性的女性加强外阴 - 会阴监测，以检测外阴癌的早期阶段。
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