HPV changes and their significance in patients with invasive squamous cell carcinoma of the vulva: a clinicopathologic study.

Records of 28 patients with invasive squamous cell carcinoma of the vulva were analyzed with regard to age-specific incidence rate, associated human papillomavirus (HPV) changes, multifocal and unifocal distribution of the lesions, and incidence of nodal metastasis. The presence of HPV changes (koilocytosis and condyloma) around the neoplastic epithelium correlated with a mean age group younger than that of those without HPV changes (47 vs 77 years). All multifocal cancers were associated with HPV changes while only 35% of unifocal lesions were so associated. Patients with multifocal disease were found to have a mean age younger than that of those with unifocal disease (44 vs. 67). When patients with microinvasion were excluded, no patients with multifocal invasive cancer and HPV changes were found to have nodal metastases. In contrast, nodal metastases were present in 59% of patients with unifocal invasive cancer.