Management and outcomes for elderly women with vulvar cancer over time
Article first published online: 24 FEB 2014
© 2014 Royal College of Obstetricians and Gynaecologists
BJOG: An International Journal of Obstetrics & Gynaecology
Volume 121, Issue 6, pages 719–727, May 2014
How to Cite
Management and outcomes for elderly women with vulvar cancer over time. BJOG 2014;719:727–565., , , , , , , , , .
- Issue published online: 17 APR 2014
- Article first published online: 24 FEB 2014
- Manuscript Accepted: 25 OCT 2013
- Deborah Kelly Center for Outcomes Research, Massachusetts General Hospital
- vulvar cancer
To examine changes over time in survival and treatment for women diagnosed with vulvar squamous cell carcinoma included in the Surveillance, Epidemiology, and End Results (SEER) Program.
USA, data obtained from the SEER Program for 1988–2009.
Women with vulvar squamous cell carcinoma.
Women were stratified by age: <50, 50–64, 65–79, and ≥80 years. Differences in survival and treatment patterns were analysed between age groups. Multivariate logistic regression models were constructed to examine treatment patterns. Kaplan–Meier and Cox proportional hazards survival methods were used to assess survival.
Main outcome measures
Vital status from the date of diagnosis until death, censoring or last follow-up.
The final study group consisted of 8553 women, 1806 (21.12%) <50 years, 2141 (25.03%) 50–64 years, 2585 (30.22%) 65–79 years, and 2021 (23.63%) >80 years old. After adjusting for patient and tumour characteristics, older women were less likely to have surgery and more likely to receive radiotherapy. Compared with women under 50 years, women 50–64 had a two-fold higher risk of death (HR 1.91, 95% CI 1.55–2.34); those 65–79 years had a four-fold higher risk of death (HR 4.01, 95% CI 3.32–4.82), and those ≥80 years had a seven-fold higher risk of death (HR 6.98, 95% CI 5.77–8.46). These trends stayed relatively constant over the time periods studied.
Women over 50 years are at a higher risk of vulvar cancer-specific mortality, which increases with age. These trends stayed relatively constant over the time periods studied.