Risk factors for unrecognized invasive carcinoma in patients with vulvar high-grade squamous intraepithelial lesion at vulvoscopy-directed biopsy / 부인종양
Journal of Gynecologic Oncology
;
: e27-2017.
Article
in English
| WPRIM
| ID: wpr-61158
ABSTRACT
OBJECTIVE:
To evaluate the prevalence and risk factors for unrecognized invasive carcinoma in a series of patients undergoing surgical excision after an office biopsy of vulvar high-grade squamous intraepithelial lesion (VHSIL).METHODS:
Two hundred and sixteen consecutive patients treated in a tertiary-level referral center for vulvar disease in north-western Italy were recruited. Patients' records were reviewed by trained personnel. Factors showing a statistically significant (p<0.05) association with detection of stromal invasion at excisional surgery in univariate analysis were further examined in a backward stepwise multiple logistic regression model.RESULTS:
The median patient age was 50 years (range, 19–88). More than 25% patients with VHSIL at biopsy had associated cervical/vaginal intraepithelial neoplasia, and more than 35% had a multifocal lesion. Invasive carcinoma was detected in surgical specimens from 24 patients (11%). The depth of stromal invasion varied between 0.1 mm and 3.0 mm with a median of 0.5 mm. In multivariate analysis, the risk of invasive carcinoma detection was greater for patients in the highest tertile of age (p=0.008), for patients with a lesion ≥20 mm in size (p=0.013) and with clitoral involvement (p<0.001), and for patients presenting with a nodular lesion (p=0.078).CONCLUSION:
Our study suggests that patient age, lesion size, clitoral involvement and nodular appearance in patients with VHSIL at vulvoscopy-directed biopsy are independently associated with the risk of unrecognized invasive carcinoma.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Referral and Consultation
/
Vulvar Diseases
/
Vulvar Neoplasms
/
Biopsy
/
Logistic Models
/
Prevalence
/
Multivariate Analysis
/
Risk Factors
/
Squamous Intraepithelial Lesions of the Cervix
/
Italy
Type of study:
Etiology study
/
Prevalence study
/
Prognostic study
/
Risk factors
Limits:
Humans
Country/Region as subject:
Europa
Language:
English
Journal:
Journal of Gynecologic Oncology
Year:
2017
Type:
Article
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