Clinico-pathological and treatment characteristics of HIV and non-HIV related vulvar cancers: Analysis of a South African cohort

Q: What was the primary objective of the study?

To describe the clinical, pathological, and treatment characteristics of vulvar cancer patients treated with surgery and/or radiotherapy at Steve Biko Academic Hospital, and to analyze disease burden and trends over time.

Q: How was the study conducted?

It was a retrospective study reviewing clinical, pathology, and radiotherapy treatment records of women with vulvar cancer who presented from January 2012 to December 2022.

Q: What did the results show about HIV status and patient age?

More than 75% of participants were women living with HIV and on antiretroviral treatment, and the mean age of HIV-positive patients was about 20 years lower than HIV-negative counterparts (p < 0.0001).

Q: What conclusion did the authors draw about age distribution and surveillance needs?

Vulvar cancer is increasingly observed in women below 50, with an upward trend in cases despite declining diagnostic age; the authors call for more vulvo-perineal surveillance of HIV-positive women to detect early-stage disease.

Sep 23, 2026

Uploaded by Bintang

Objective describes clinical, pathological, and treatment characteristics of vulvar cancer patients undergoing surgery and/or radiotherapy at Steve Biko Academic Hospital, including absolute and relative disease burden and time trends. Methods report a retrospective review of women presenting to gynecology oncology and radiation oncology between January 2012 and December 2022. Results include 317 cases, mean age 45.1±12.7, majority on antiretroviral therapy, high rates of squamous carcinoma, advanced-stage presentation, and curative radiation doses. Conclusion highlights increasing incidence in women under 50 and the need for surveillance of HIV-positive women.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages17

Reading Time43 min

AccessFree to download

Abstract

Objective

Materials and methods

Results

Conclusion

Introduction

Background and global burden

South Africa trends

Treatment overview

OPEN ACCESS Citation: Sajo AE, Mnisi EF, Bassa S, Visser C, Dreyer G (2025) Clinico-pathological and treatment characteristics of HIV and non-HIV related vulvar cancers: Analysis of a South African cohort. PLoS One 20(7): e0327119 . [https://doi.org/10.1371/journal.pone.0327119](https://doi.org/10.1371/journal.pone.0327119) Editor: Milad Khorasani, Neyshabur University of Medical Sciences, IRAN, ISLAMIC REPUBLIC OF Received: November 22, 2024 Accepted: June 10, 2025 Published: July 1, 2025 Peer Review History: PLOS recognizes the benefits of transparency in the peer review process; therefore, we enable the publication of all of the content of peer review and author responses alongside final, published articles. The editorial history of this article is available here: [https://doi.org/10.1371/journal](https://doi.org/10.1371/journal). pone.0327119 Copyright: © 2025 Sajo et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, RESEARCH ARTICLE Clinico-pathological and treatment characteristics of HIV and non-HIV related vulvar cancers: Analysis of a South African cohort Adekunle Emmanuel Sajo1*, Edwin Francis Mnisi1,2, Sheynaz Bassa3,4, Cathy Visser1, Greta Dreyer1,5 1 Department of Obstetrics and Gynaecology, Gynaecologic Oncology Unit, University of Pretoria, Pretoria, South Africa, 2 Department of Obstetrics and Gynaecology, Kalafong Provincial Tertiary Hospital, Pretoria, South Africa, 3 Department of Radiation Oncology, University of Pretoria, Pretoria, South Africa, 4 Department of Radiation Oncology, Steve Biko Academic Hospital, Pretoria, South Africa, 5 Department of Obstetrics and Gynaecology, Gynaecologic Oncology Unit, Steve Biko Academic Hospital, Pretori, South Africa * [adekunlesajo@yahoo.com](adekunlesajo@yahoo.com) Abstract Objective The main objective of this study was to describe the clinical, pathological and treatment characteristics of patients with vulvar cancer who had surgery and or radiotherapy at Steve Biko Academic Hospital. The absolute and relative disease burden, trends over the time period were also analyzed. Materials and methods This was a retrospective study that described women with vulvar cancer who presented to the Gynaecology Oncology and Radiation Oncology departments of the hospital between January 2012 and December 2022. Their clinical, pathology and radiotherapy treatment records were reviewed for this study. Results 317 vulvar cancer cases between 2012 and 2022 were included in the analysis. The average age was 45. 1±12 .7. Forty percent of the participants were younger than 40 years. More than 75% of them were women living with HIV and were all on antiretroviral treatment. The average age of those who were HIV positive was 20 years lower than their HIV negative counterparts, p <0 .0001. Their mean haemoglobin (Hb) at presentation was 10.7g/dL. Squamous cell carcinoma was the most common histological type in 96.5% of cases. Sixty four percent of the cases presented in advanced stage. About 48% of those who had primary radiation received curative doses. The median time to completion of radiotherapy treatment was higher among those who received primary radiotherapy as compared to those who received adjuvant PLOS One | [https://doi.org/10.1371/journal.pone.0327119](https://doi.org/10.1371/journal.pone.0327119) July 1, 2025 1 / 17 and reproduction in any medium, provided the original author and source are credited. Data availability statement: All relevant data are within the paper and its Supporting information files. Funding: The author(s) received no specific funding for this work. Competing interests: The authors have declared that no competing interests exist. treatment, 51.5 vs 46 days, p 0.039. The annual average age decreased from 56 years to as low as 40 years, a mean difference of 16 years, p 0.012. Conclusion It is striking

FAQs

What was the primary objective of the study?

To describe the clinical, pathological, and treatment characteristics of vulvar cancer patients treated with surgery and/or radiotherapy at Steve Biko Academic Hospital, and to analyze disease burden and trends over time.

How was the study conducted?

It was a retrospective study reviewing clinical, pathology, and radiotherapy treatment records of women with vulvar cancer who presented from January 2012 to December 2022.

What did the results show about HIV status and patient age?

More than 75% of participants were women living with HIV and on antiretroviral treatment, and the mean age of HIV-positive patients was about 20 years lower than HIV-negative counterparts (p < 0.0001).

What conclusion did the authors draw about age distribution and surveillance needs?

Vulvar cancer is increasingly observed in women below 50, with an upward trend in cases despite declining diagnostic age; the authors call for more vulvo-perineal surveillance of HIV-positive women to detect early-stage disease.

Sep 23, 2026

Uploaded by Bintang