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• W2287304280 abstract "This survey reports the past 38 years of experience with 192 cases of carcinoma of the vulva seen and treated at the Johns Hopkins Hospital. The review stresses the increased incidence of in situ neoplasia and the importance of individualization of therapy. Also the changing concepts in terminology (eg, the leukoplakic vulvitis of the past is the dystrophy of the present) suggest that the precursory alterations of previous discussions must be reviewed in the light of such an altered nomenclature. Features of epidemiologic and histologic importance are discussed.Vulvar neoplasia as seen at the Johns Hopkins Hospital during a 38-year period (1935-1972) is reviewed. Of 1385 tissue specimens, 1053 were benign and 332 were malignant lesions. Of the malignant lesions, 246 were squamous cell carcinoma, both in situ and invasive. Of these, 192 were treated and followed and are reported on. There were 71 cases of in situ and 121 of invasive cancer. Of the patients, 64% were white and 36% were nonwhite, which corresponds to the patient population treated at the hospital. Ages of patients ranged from 21 to 86 years, with a median of 50 years. Of those with invasive cancer, 75% were postmenopausal and none was under the age of 30 years. There was a 29% incidence of nulliparity and a 64% incidence of obesity. Diabetes was noted in 64%. Syphilis was discovered in 26%. These patients had a high risk of being exposed to other venereal infections, particularly herpes which is suspect as a precursor of neoplasia. Vurrucous carcinoma are also likely to be of viral origin. Other malignancies were also present in 20% of patients. There was 1 case of chronic clyphocytic leukemia. Presenting symptoms were a lump, a white patch, pruritus, or bleeding. Pruritus was present in 46%. A leukoplakialike appearance was noted in most of the in situ lesions. Multicentric foci of origin were demonstrated in 35%, mostly in the in situ cases. Of the invasive cancers 60% were well differentiated and 11% were verrucous. Multiple histologic patterns were present in many cases. In 167 patients (67%), the initial treatment was surgical. Postoperative radiation was used in 30% of those with invasive cancer. Local recurrences followed in 22%. In those with multicentric foci the recurrence rate was 48%. 44 patients were known to have died, mostly from other causes. Survival was directly related to the stage of the disease at the time of initial diagnosis and treatment." @default.
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• W2287304280 date "1977-04-01" @default.
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• W2287304280 title "Primary vulvar neoplasia: a review of in situ and invasive carcinoma, 1935-1972." @default.
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