Next Article in Journal
AAV Mediated Delivery of Myxoma Virus M013 Gene Protects the Retina against Autoimmune Uveitis
Previous Article in Journal
Predicting Residual Function in Hemodialysis and Hemodiafiltration—A Population Kinetic, Decision Analytic Approach
Open AccessArticle

Changes in the Clinicopathological Demographics of Vulvar Cancer in Japan: Increasing Oldest-Old, Stage Shifting, and Decreasing Cohort-Level Survival

Department of Obstetrics and Gynecology, Kurume University School of Medicine, Kurume, Fukuoka 830-0011, Japan
Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, CA 90033, USA
Department of Health Management, Tokai University, Hiratsuka, Kanagawa 259-1292, Japan
Department of Gynecologic Oncology, Hyogo Cancer Center, Akashi, Hyogo 673-0021, Japan
Department of Gynecologic Oncology, Cancer Institute Hospital of JFCR, Tokyo 135-0063, Japan
Department of Gynecologic Oncology, National Hospital Organization Shikoku Cancer Center, Matsuyama, Ehime 791-0245, Japan
Department of Gynecologic Oncology, Shizuoka Cancer Center, Shizuoka 411-0934, Japan
Department of Obstetrics and Gynecology, St. Marianna University School of Medicine, Kawasaki, Kanagawa 216-8511, Japan
Department of Obstetrics and Gynecology, Tohoku University School of Medicine, Sendai, Miyagi 980-8574, Japan
Department of Obstetrics and Gynecology, Yokohama City University Hospital, Yokohama, Kanagawa 236-0004, Japan
Department of Gynecology, Kanagawa Cancer Center, Yokohama, Kanagawa 241-8515, Japan
Department of Gynecology, Saitama Cancer Center, Saitama 362-0806, Japan
Department of Gynecology, Niigata Cancer Center Hospital, Niigata 951-8133, Japan
Department of Obstetrics and Gynecology, Niigata University School of Medicine, Niigata 951-8510, Japan
Department of Obstetrics and Gynecology, Tokai University Hospital, Isehara, Kanagawa 259-1193, Japan
Authors to whom correspondence should be addressed.
Abstract of the study was presented at the 2019 Congress Meeting for European Society for Medical Oncology, Barcelona, Spain, 27 September–1 October 2019.
Authors contributed equally to the work.
J. Clin. Med. 2019, 8(12), 2081;
Received: 30 October 2019 / Revised: 18 November 2019 / Accepted: 23 November 2019 / Published: 29 November 2019
(This article belongs to the Section Obstetrics & Gynecology)
Background: To examine trends in the clinicopathological characteristics of vulvar cancer in Japan. Methods: This is a nationwide retrospective study examining consecutive women with vulvar cancer between 2001 and 2010 in Japan (n = 1061). Temporal trends in demographics, tumor characteristics, and survival were assessed by cohort-level analysis. The National Cancer Institute’s Surveillance, Epidemiology, and End Result Program was used for external validation (n = 10,154). Results: The number of oldest-old women aged ≥80 years significantly increased (from 18.0% in 2001 to 30.6% in 2010; 70.5% relative increase) in the study period. A stage shift was observed, with stage I disease decreasing from 43.0% to 34.0% (21.0% relative decrease), and tumors with distant metastases increasing from 23.2% to 35.6% (53.3% relative increase, p < 0.05). The number of women who underwent surgical treatment decreased from 84.0% to 69.7% (17.0% relative decrease), whereas utilization of radiotherapy increased from 34.4% to 43.2% (25.7% relative increase) over time (p < 0.05). In the cohort-level analysis, the five-year survival rates significantly decreased from 2001 to 2010 (p < 0.05), specifically, 66.9% to 51.0% for progression-free survival (23.7% relative decrease), 79.5% to 67.9% for cause-specific survival (14.6% relative decrease), and 74.9% to 62.3% for overall survival (16.9% relative decrease). In the patient-level analysis, oldest-old women were less likely to undergo surgical treatment and were independently associated with decreased survival (p < 0.05). In the US cohort, the number of oldest-old women (25.2% to 27.8%) and the five-year cause-specific survival rate (81.8% to 79.9%) remained unchanged during the study period (p > 0.05). Conclusion: Demographics and outcomes of vulvar cancer in Japan significantly changed during the study period. An increasing oldest-old population and a stage shift to more metastatic disease resulted in a cohort-level decrease in survival rates. View Full-Text
Keywords: vulvar cancer; trends; demographics; elderly; survival; Japan vulvar cancer; trends; demographics; elderly; survival; Japan
Show Figures

Figure 1

MDPI and ACS Style

Nishio, S.; Matsuo, K.; Shibata, T.; Yamaguchi, S.; Kanao, H.; Takehara, K.; Kado, N.; Tozawa, A.; Tokunaga, H.; Matsunaga, T.; Kato, H.; Horie, K.; Kikuchi, A.; Enomoto, T.; Mikami, M. Changes in the Clinicopathological Demographics of Vulvar Cancer in Japan: Increasing Oldest-Old, Stage Shifting, and Decreasing Cohort-Level Survival . J. Clin. Med. 2019, 8, 2081.

Show more citation formats Show less citations formats
Note that from the first issue of 2016, MDPI journals use article numbers instead of page numbers. See further details here.

Article Access Map by Country/Region

Back to TopTop