| Article ID | Journal | Published Year | Pages | File Type |
|---|---|---|---|---|
| 3947150 | Gynecologic Oncology | 2011 | 5 Pages |
ObjectiveTo determine the disease characteristics and comorbidities predictive of vulvar cancer specific mortality and five year overall survival among older women, ages 65 and above.MethodsA retrospective analysis was conducted of women diagnosed with vulvar cancer at a single regional cancer center from 1989 to 2003, with a follow up to 2009. Treatment records were extracted for: demographics and treatment information, Eastern Cooperative Oncology Group (ECOG) performance status and Charlson comorbidity index score. Probability of death from vulvar cancer was estimated using cumulative incidence, treating death by other known and unknown causes as competing risks. Predictors of overall survival were determined using multivariate Cox regression analyses.ResultsOne hundred forty-six women were identified, with a median age at diagnosis of 79 years (range 65–95). Median follow up was 5.0 years (range 0.1–16.7 years). The cumulative incidence of vulvar cancer-specific mortality was 13% (95% CI: 0.08–0.19) at year one, 24% (95% CI: 0.17–0.31) at year three and 26% (95% CI: 0.19–0.33) at year five. Use of adjuvant therapy or surgical procedure performed did not differ by age at diagnosis (p = 0.807 and 0.663) according to age group (65–74, 74–84 and 85+). Increasing age, Charlson comorbidity index score, lymph node involvement and type of surgery performed were associated with increased risk of death from any cause (all p < 0.05).ConclusionAmong women aged ≥ 65, vulvar cancer specific mortality was most significant in the first three years after diagnosis. Conversely other causes of mortality which can be attributed to comorbid conditions steadily increased with time.
Research highlights►Analysis of vulvar cancer mortality and overall five year survival in older women. ►Age, stage, lymph node spread are predictive of vulvar cancer specific mortality. ►Charlson comorbidity index score of 2+ is associated with decreased overall survival.
