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Patient’s demographic characteristics
| Demographic data | Benign (n = 527) | Premalignant (n = 59) | Malignant (n = 114) | P* |
|---|---|---|---|---|
| Age (mean ± SD) | 45.1 ± 15.6 | 52.9 ± 14.5 | 56.9 ± 16.6 | <0.001** |
| Parity (%) | ||||
| 0 | 192 (36.4) | 13 (22.1) | 21 (18.4) | <0.001** |
| 1 | 159 (30.2) | 14 (23.7) | 17 (14.9) | 0.002** |
| 2 | 106 (20.1) | 16 (27.1) | 23 (20.2) | 0.494 |
| >2 | 70 (13.3) | 16 (27.1) | 53 (46.5) | <0.001** |
| Postmenopause (%) | 181 (34.3) | 38 (64.4) | 74 (64.9) | <0.001** |
| Presenting symptom (%) | ||||
| Mass | 425 (80.6) | 24 (40.7) | 86 (75.4) | <0.001** |
| Rash | 73 (13.8) | 28 (47.5) | 24 (21.1) | <0.001** |
| Itching | 29 (5.6) | 7 (11.8) | 4 (3.5) | 0.674 |
Lesion characteristics
| Demographic data | Benign (n = 527) | Premalignant (n = 59) | Malignant (n = 114) | P* |
|---|---|---|---|---|
| Location (%) | ||||
| Labia majora | 273 (51.9) | 37 (62.7) | 57 (50.0) | 0.240 |
| Labia minora | 122 (23.1) | 10 (16.9) | 24 (21.1) | 0.523 |
| Mon pubis | 47 (8.9) | 3 (5.1) | 9 (7.8) | 0.558 |
| Anterior fourchette | 30 (5.7) | 6 (10.2) | 6 (5.3) | 0.365 |
| Bartholin’s gland | 36 (6.8) | 0 (0) | 2 (1.8) | 0.015 |
| Clitoris | 9 (1.7) | 2 (3.4) | 14 (12.2) | <0.001** |
| Posterior fourchette | 10 (1.9) | 1 (1.7) | 2 (1.8) | 0.990 |
| Size (cm) (%) | ||||
| ≤2 cm | 434 (82.4) | 21 (35.6) | 23 (20.2) | <0.001** |
| >2–4 cm | 71 (13.5) | 24 (40.7) | 44 (38.6) | <0.001** |
| >4 cm | 22 (4.1) | 14 (23.4) | 47 (41.2) | <0.001** |
| Color (%) | ||||
| Unchanged skin color | 364 (69.1) | 44 (74.6) | 29 (25.4) | <0.001** |
| Hypopigment | 111 (21.1) | 8 (13.5) | 47 (41.2) | 0.004** |
| Erythematous | 26 (4.9) | 7 (11.9) | 28 (24.6) | <0.001** |
| Hyperpigment | 26 (4.9) | 0 (0) | 10 (8.8) | 0.662 |
Univariate and multivariate analysis to predict vulvar malignancy risk
| Factors | Univariate analysis | Multivariate analysis | ||||
|---|---|---|---|---|---|---|
| OR | 95% CI | P | OR | 95% CI | P | |
| Age (years) | 1.04 | 1.03–1.05 | <0.001* | 1.00 | 0.97–1.02 | 0.890 |
| Menopause (yes, no) | 3.51 | 2.45–5.03 | <0.001* | 1.83 | 0.83–4.05 | 0.130 |
| Parity (times) | 1.41 | 1.28–1.56 | <0.001* | 1.19 | 1.04–1.36 | 0.010* |
| Size (cm) | 2.10 | 1.84–2.40 | <0.001* | 2.00 | 1.73–2.31 | <0.001* |
| Location | ||||||
| Labia majora | 6.19 | 1.46–26.23 | 0.013* | 3.26 | 0.72–14.7 | 0.130 |
| Labia minora | 5.02 | 1.14–21.89 | 0.032* | 4.20 | 0.91–19.6 | 0.070 |
| Clitoris | 32.00 | 6.19–165.2 | <0.001* | 15.67 | 2.72–90.9 | 0.002* |
| Color | ||||||
| Hyperpigment | 1.92 | 0.89–4.15 | 0.098 | 2.38 | 0.94–6.06 | 0.068 |
| Hypopigment | 2.47 | 1.64–3.72 | <0.001* | 1.14 | 0.68–1.91 | 0.625 |
| Erythematous | 6.71 | 3.81–11.83 | <0.001* | 2.41 | 1.11–5.24 | 0.026* |
Trends of vulvar premalignant and malignant lesions
| Year 2002–2008 (n = 342) | Year 2009–2015 (n = 358) | P | |
|---|---|---|---|
| Malignant vulvar lesion | 45 (13.2%) | 69 (19.3%) | 0.028* |
| Premalignant vulvar lesion | 25 (7.3%) | 34 (9.5%) | 0.298 |
Diagnosis of vulvar lesion in number and percentage
| Malignant (n = 114) | Benign (n = 527) | ||
|---|---|---|---|
| Squamous cell | 55 (48.2) | Fibroepithelial polyp | 126 (23.9) |
| carcinoma | |||
| Malignant melanoma | 12 (10.5) | Epidermal inclusion cyst | 84 (15.9) |
| Adenocarcinoma | 10 (8.8) | Inflammation | 72 (13.7) |
| Invasive Paget’s | 8 (7.0) | Condyloma acumi- | 52 (9.9) |
| disease | nata | ||
| Soft tissue tumors | 7 (6.2) | Seborrheic keratosis | 26 (4.9) |
| Verrucous carcinoma | 5 (4.4) | Nevus | 22 (4.2) |
| Basal cell carcinoma | 4 (3.5) | Hydradenoma | 17 (3.2) |
| papilliferum | |||
| Neuroendocrine | 4 (3.5) | Lichen sclerosus | 15 (2.8) |
| tumors | |||
| Others | 9 (7.9) | Hyperkeratosis | 12 (2.3) |
| Lipoma | 10 (1.9) | ||
| Premalignant (n = 59) | Others | 91 (17.3) | |
| VIN1 | 20 (33.9) | ||
| VIN3 | 19 (32.2) | ||
| Paget’s disease | 16 (27.1) | ||
| VIN2 | 4 (6.8) |