Demographic characteristics and the clinical profile of Vulvar cancer patients treated at Tikur Anbessa Specialized Hospital, a five years retrospective study
Keywords:Key words: Cancer, vulva cancer, demographic aspect, clinical profile, HIV
Background: Vulvar cancer is a rare disease that occurs most often in older women; however, this is not reflected in clinical practice at Tikur Anbessa Hospital (TAH). Overall there is limited information regarding vulvar cancer in Ethiopia.
Aim: The aim of this study was to describe demographic characteristics and the clinical profile of Vulvar Cancer patients treated at Tikur Anbessa Specialized Hospital.
Methods: This is a retrospective study. Data on primary vulvar cancer patients managed between August 30 2012 and August 30 2017 were gathered from patientsâ€™ chart and analyzed.
Results: The median/mean age was 39/43.17 ranging from 22 to 85 years. The patients presented with more than one symptom. The mean duration of the symptoms was about 2 years. Labium majus(91.5%), labium minus (89%) were mainly affected. In most (79.7%) patients the disease was locally advanced. Sixty six percent of the cases were positive for HIV. The mean/ median duration of HIV infection was 72.14/72 months. All of them were taking HAART. The majority (32.2%) were treated with chemo-radiation followed by surgery alone (16.9%). A Surgical procedure was done for 22 patients. Few patients developed complications.
Conclusion: Vulvar cancer in Ethiopia appears to be a burden of mainly the young and HIV positive patients. Most present in late stage of the disease despite visiting a health care facility for HIV care/HAART and long standing symptoms. Delivering education about vulvar cancer to Patients, particularly HIV positive ones, and health care providers may ameliorate the disease burden in Ethiopia.
de Martel C, Ferlay J, Franceschi S, al. e. Global burden of cancers attributable to infections in 2008: a review and synthetic analysis. Lancet Oncol. 2012;13(6):607-15.
Hacker NF,et al. Cancer of the vulva. Int J Gynaecol Obstet. 2015;131 76-8.
Hampl M, al. e. New aspects of vulvar cancer: changes in localization and age of onset. Vulvar cancer in women less than fifty in United States, 1980-2005. Gynecol Oncol. 2009.
Mary Ann Dadzie, al. e. Vulva cancer in Ghana - Review of a hospital based data. Gynecologic Oncology Reports. 2017; 108-111.
Zongo, et al. Cancer of the vulva in Burkina Faso: a hospital-based case series. Infect Agents and Cancer 2016;11:33.
Siddiqui N. The management of vulval cancer. Obstet Gynaecol. 2002;12 (2): 97-103.
Mary Ann Dadzie et al. Vulva cancer in Ghana â€“ Review of a hospital based data. Gynecologic Oncology Reports 2017;108-111.
Thakur, et al. Clinical analysis of vulvar carcinoma. . Gynecology 2013. 2013.
Singh DK, Anastos K, Hoover DR, ;. ea. Human papillomavirus infection and cervical cytology in HIV-infected and HIV-uninfected Rwandan women. J Infect Dis. 2009;199:1851-61.
Denny L, Boa R, Williamson AL, al. e. Human papillomavirus infection and cervical disease in human immunodeficiency virus-1-infected women. Obstet Gynecol. 2008;111:1380-7.
Brickman C, JM P. Human papillomavirus in the HIV-infected host: epidemiology and pathogenesis in the antiretroviral era. 2015.
Hampl M, Deckers-Figiel S, Hampl JA, et al. aspects of vulvar cancer: changes in localization and age of onset. Gynecol Oncol. 2009.
Singh, et al. A cohort study of vulvar cancer. Indian Journal of Cancer 2016;53 (3).
Hacker NF, Eifel PJ, J vdV. FIGO cancer report 2012. Cancer of the vulva. Int J Gynecol Obstet. 2012;119 90â€‘6.
Okolo CA, Odubanjo MO, Awolude OA, et al. A review of vulvar and vaginal cancers in Ibadan, Nigeria. . Am J Med Sci 2013;6:76â€‘81.
Madeleine MM, Daling JR, Carter JJ, Wipf GC, Schwartz SM, McKnight B, et al. Cofactors with human papillomavirus in a population-based study of vulvar cancer. J Natl Cancer Inst. 1997;89:1516- 23.
Canavan TP, D. C. Vulvar cancer. Am Fam Physician. 2002;66:1269-74.
Al-Ghamdi A et al. Vulvar squamous cell carcinoma in young women: a clinicopathologic study of 21 cases. . Gynecol Oncol. 2002 84(1):94-101.
Alkatout, et al. Vulvar cancer: epidemiology, clinical presentation, and management options International Journal of Womenâ€™s Health. 2015;7.
Ahizechukwu C Eke et al. Management options for vulvar carcinoma in a low resource setting. World J Surg Oncol. 2010;8:94.
Nkyekyer, K. Pattern of gynaecological cancers in Ghana. . East Afr Med J. 2000;77 10.
Stroup AM et al. Demographic, Clinical, and Treatment Trends among Women Diagnosed with Vulvar Cancer in the U.S. Gynecol Oncol. 2008 108(3):577-83.
Clemente et al. Multiple preinvasive and invasive HPV-related lesions of the anogenital tract in a female patient with HIV infection:A case report Medicine (2017) 96:4 Cervical Cancer, an open access journal
Sefinew Migbaru Abate https://www.omicsonline.org/open-access/trends-of-cervical-cancer in Ethiopia for the years 1997-2012
Alkatout et al. Vulvar cancer: epidemiology, clinical presentation, and management options International Journal of Womenâ€™s Health 2015:7
Stoup AM et, al. Demographic, Clinical, and Treatment Trends Among Women Diagnosed with Vulvar Cancer in the U.S. Gynecol Oncol. 2008 March; 108(3): 577â€“583.
Smith et al. Human Papillomavirus Type-Distribution in Vulvar and Vaginal Cancers and Their Associated Precursors
Faber et al. Prevalence and type distribution of human papillomavirus in squamous cell carcinoma and intraepithelial neoplasia of the vulva. Int J Cancer. 2017 Sep 15; 141(6):1161-1169
Siriaunkgul et al. HPV Detection and Genotyping in Vulvar Squamous Cell Carcinoma in Northern Thailand. Asian pacific Journal of Cancer Prevention. 2014, 15 (8), 3773-3778.