title: Vulvar cancer in Tunisia: Epidemiological and clinicopathological features multicentric study.
abstract: OBJECTIVE
  To describe for the first time the epidemiologic and clinico-pathologic characteristics of vulvar cancer in Tunisia.
  
  
  METHODS
  Two parts are distinguished in this study: Part1: Multicentric retrospective study about the characteristics of all cancer cases diagnosed during a 17-years period (January 1998-December 2014) in three departments of Gynecology and Obstetrics: one in south Tunisia and two in the capital. Part 2: To determine the Incidence trend of invasive vulvar cancer in North Tunisia 1994-2009, on the basis of North Cancer Registry of Tunisia.
  
  
  RESULTS
  A total of 76 cases of vulvar cancer were recorded. The median age at diagnosis was 65.4years and 86.9% of patients were more than 55years old. The symptomatology was dominated by vulvar pruritus in 48.7%. The average size of the tumor was 3.96cm. Stage III was the most frequent (53.7%) followed by stage II (28.3%). Only 10.4% of tumors were at stage I. The most common histologic type of vulvar malignancy was squamous cell carcinoma (SCC) (94.7%). Standardized incidence varied from 1.2/100 000 (1994) to 0.5/100 000 (2009). There was significant decrease of Standardized incidence (APC of -8.8% per year, 95% CI: -5.5%, -9.0%-p<0.001).
  
  
  CONCLUSIONS
  Vulvar cancer in Tunisia is a rare disease, occurs mostly in elderly women, and is diagnosed at advanced stages. Our findings emphasize that a greater effort should be made to facilitate early diagnosis, as treatment in earlier stages is less extensive and potentially curative.
authors.affiliation: C Department of Obstetrics and Gynecology, Tunis Maternity and Neonatology Center, Tunis El Manar University, Tunisia. Electronic address: mehdikehila@hotmail.fr.
authors.forename: Mehdi
authors.initials: M
authors.lastname: Kehila
authors.affiliation: Obstetrics and Gynecology Department, Hedi Chaker Teaching Hospital, Sfax, Tunisia.
authors.forename: Souad
authors.initials: S
authors.lastname: Harabi
authors.affiliation: C Department of Obstetrics and Gynecology, Tunis Maternity and Neonatology Center, Tunis El Manar University, Tunisia.
authors.forename: Raoudha
authors.initials: R
authors.lastname: Mhiri
authors.affiliation: C Department of Obstetrics and Gynecology, Tunis Maternity and Neonatology Center, Tunis El Manar University, Tunisia.
authors.forename: Omar
authors.initials: O
authors.lastname: Touhami
authors.affiliation: C Department of Obstetrics and Gynecology, Tunis Maternity and Neonatology Center, Tunis El Manar University, Tunisia.
authors.forename: Hassine Saber
authors.initials: HS
authors.lastname: Abouda
authors.affiliation: Department of Obstetrics and Gynecology, PB 4000 Farhat Hached Teaching Hospital, Sousse University, Tunisia.
authors.forename: Abdeljalil
authors.initials: A
authors.lastname: Khlifi
authors.affiliation: Department of Epidemiology and Preventive Medicine, Tunis El Manar University, Tunisia.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Hsairi
authors.affiliation: A Department of Obstetrics and Gynecology, Tunis Maternity and Neonatology Center, Tunis El Manar University, Tunisia.
authors.forename: Dalenda
authors.initials: D
authors.lastname: Chelli
authors.affiliation: Obstetrics and Gynecology Department, Hedi Chaker Teaching Hospital, Sfax, Tunisia.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Derbel
authors.affiliation: Obstetrics and Gynecology Department, Hedi Chaker Teaching Hospital, Sfax, Tunisia.
authors.forename: Sahbi
authors.initials: S
authors.lastname: Kebaili
authors.affiliation: Pathology Department of Salah Azaiez Institute, Tunis El Manar University, Tunisia.
authors.forename: Nadia
authors.initials: N
authors.lastname: Boujelbane
authors.affiliation: Obstetrics and Gynecology Department, Hedi Chaker Teaching Hospital, Sfax, Tunisia.
authors.forename: Kais
authors.initials: K
authors.lastname: Chaabene
authors.affiliation: C Department of Obstetrics and Gynecology, Tunis Maternity and Neonatology Center, Tunis El Manar University, Tunisia.
authors.forename: Mohamed Badis
authors.initials: MB
authors.lastname: Chanoufi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000453:epidemiology* / Q000473:pathology; D005260:Female; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging; D012042:Registries; D012189:Retrospective Studies; D014416:Tunisia / Q000453:epidemiology; D014846:Vulvar Neoplasms / Q000453:epidemiology* / Q000473:pathology
keywords: Clinicopathological study; Incidence trend; Tunisia; Vulvar cancer