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European Journal of Gynaecological Oncology  2019, Vol. 40 Issue (5): 815-819    DOI: 10.12892/ejgo5124.2019
Original Research Previous articles | Next articles
Clinical characteristics and correlates of vulvar high-grade squamous intraepithelial lesion involving the clitoris
M. Preti1, *(), L. Bucchi2, S. Privitera3, S. Cosma1, N. Gallio1, C. Benedetto1, L. Micheletti1
1Department of Obstetrics and Gynaecology, University of Torino, Torino, Italy
2Romagna Cancer Registry, Romagna Cancer Institute (Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, IRST, IRCCS), Meldola, Forlì, Italy
3Department of Pathology and Cytology of Female Cancer, Childhood Cancer, and Rare Cancers, AOU Città della Salute e della Scienza, Torino, Italy;
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Purpose: Vulvar high-grade squamous intraepithelial lesion (VHSIL) involving the clitoris is a rare and ill-defined condition. The authors evaluated the patient characteristics associated with clitoral vs. non-clitoral VHSIL and the clinical correlates of the disease. Materials and Methods: Data from 216 consecutive patients seen at an Italian tertiary referral centre (1981-2014) were analysed using the chi-square test and multiple logistic regression models. Results: Clitoral VHSIL was detected in 41 (19%) patients. HIV infection, associated cervical and vaginal intraepithelial neoplasia, and multifocality were significantly (p < 0.05) associated with clitoral VHSIL. In multivariate analysis, multifocality retained a strong effect [odds ratio (OR), 17.5; 95% confidence interval (CI), 6.9-44.7]. Clitoral VHSIL was a weak risk factor for patient loss to follow-up in univariate (24.4% vs. 13.1%; p = 0.072) and multivariate analysis (OR, 2.13; 95% CI, 0.92-4.92). The 60-month persistence/recurrence-free survival was non-significantly lower for patients with clitoral VHSIL. Conclusion: Multifocality was independently associated with clitoral VHSIL and this, in turn, with patient loss to follow-up.

Key words:  Clitoris      Vulvar neoplasms      Vulvar high-grade squamous intraepithelial lesion      Vulvoscopy     
Published:  10 October 2019     
*Corresponding Author(s):  M. PRETI     E-mail:

Cite this article: 

M. Preti, L. Bucchi, S. Privitera, S. Cosma, N. Gallio, C. Benedetto, L. Micheletti. Clinical characteristics and correlates of vulvar high-grade squamous intraepithelial lesion involving the clitoris. European Journal of Gynaecological Oncology, 2019, 40(5): 815-819.

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