Vulvar cancer in young women: demographic features and outcome evaluation

• Published in: American journal of obstetrics and gynecology 2009-06, Vol.200 (6), p.645.e1-645.e5
• Main Authors: Lanneau, Grainger S., MD, Argenta, Peter A., MD, Lanneau, Marion S., MS, Riffenburgh, Robert H., PhD, Gold, Michael A., MD, McMeekin, D. Scott, MD, Webster, Nancy, MD, Judson, Patricia L., MD
• Format: Article
• Language: English
• Subjects: Adult; Age Factors; Biological and medical sciences; Carcinoma, Squamous Cell - diagnosis; Carcinoma, Squamous Cell - epidemiology; Demographic; Female; Female genital diseases; Gynecology. Andrology. Obstetrics; Humans; Medical sciences; Middle Aged; Obstetrics and Gynecology; outcome; Risk Factors; Tumors; vulvar cancer; Vulvar Neoplasms - diagnosis; Vulvar Neoplasms - epidemiology; young; Young Adult
• ISSN: 0002-9378; 1097-6868
• DOI: 10.1016/j.ajog.2009.01.014

Objective The objective of the study was to identify prognostic and environmental factors associated with vulvar carcinoma in young women. Study Design This study was a review of patients younger than 45 years who were diagnosed with vulvar squamous cell carcinoma between 1994 and 2006. Results Fifty-six patients were identified. Median age was 38 years and median follow-up was 25.3 months. Fifty-eight percent of patients presented with stage I disease; 77% smoked tobacco. Of patients with advanced disease, 53.3% were smokers, 40% had human papillomavirus (HPV) exposure, 46.7% had a history of vulvar intraepithelial neoplasia (VIN), and 6.7% were immunocompromised. Symptoms were present for more than 12 months in 47%, but symptom duration did not correlate with stage ( P = .42) or positive lymph nodes ( P = .28). Disease recurred in 10.7% and 5.4% died of disease. Conclusion Young women with vulvar cancer tend to have early-stage disease, smoke, have a history of HPV, and have VIN. Many of the factors that place these patients at continuous risk are modifiable.