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Recurrence patterns identify aggressive form of human papillomavirus-dependent vulvar cancer.
McWhirter, Rebekah E; Otahal, Petr; Taylor-Thomson, Debbie; Maypilama, Elaine Lawurrpa; Rumbold, Alice R; Dickinson, Joanne L; Thorn, Jane C; Boyle, Jacqueline A; Condon, John R.
Afiliação
  • McWhirter RE; Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia.
  • Otahal P; Centre for Law and Genetics, Faculty of Law, University of Tasmania, Hobart, Tasmania, Australia.
  • Taylor-Thomson D; Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia.
  • Maypilama EL; Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia.
  • Rumbold AR; Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia.
  • Dickinson JL; Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia.
  • Thorn JC; Robinson Research Institute, University of Adelaide, Adelaide, South Australia, Australia.
  • Boyle JA; South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia.
  • Condon JR; Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia.
Aust N Z J Obstet Gynaecol ; 60(2): 231-237, 2020 04.
Article em En | MEDLINE | ID: mdl-31603537
BACKGROUND: Vulvar cancer is rare and, as a result, is understudied. Treatment is predominantly surgery, irrespective of the type of vulvar cancer, and is associated with physical, emotional and sexual complications. A cluster of human papillomavirus (HPV)-dependent vulvar cancer patients was identified in Arnhem Land Northern Territory (NT), Australia, in which young Indigenous women were diagnosed at 70 times the national incidence rate. AIMS: To assess whether women from the Arnhem Land cluster differ from women with vulvar squamous cell carcinoma (VSCC) and vulvar intraepithelial neoplasia (VIN) resident elsewhere in the NT in recurrence after treatment, disease progression and mortality. MATERIALS AND METHODS: A retrospective cohort study of NT-resident women diagnosed with VIN or invasive vulvar cancer (VSCC) between 1 January 1993 and 30 June 2015 was undertaken. Time to recurrence was assessed using cumulative incidence plots and Fine and Gray competing risk regression models. Mean cumulative count was used to estimate the burden of recurrent events. RESULTS: Indigenous women from Arnhem Land experienced more recurrences after treatment than non-Indigenous women, the cancers recurred faster, and Indigenous women have worse survival at five years. CONCLUSIONS: In characterising the epidemiological features of this cluster, we have identified a particularly aggressive form of vulvar cancer. This provides a unique opportunity for elucidating the aetiopathological pathways driving vulvar cancer development that may ultimately lead to preventive and therapeutic targets for this neglected malignancy. Further, these findings have important implications for clinical practice and HPV vaccination policy in the affected population.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Papillomaviridae / Neoplasias Vulvares / Carcinoma in Situ / Carcinoma de Células Escamosas / Povos Indígenas / Recidiva Local de Neoplasia Idioma: En Ano de publicação: 2020 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Papillomaviridae / Neoplasias Vulvares / Carcinoma in Situ / Carcinoma de Células Escamosas / Povos Indígenas / Recidiva Local de Neoplasia Idioma: En Ano de publicação: 2020 Tipo de documento: Article