Primary treatment and relative survival by stage and age in vaginal carcinoma: a population-based SweGCG study.
This study aimed to investigate treatment patterns and survival outcomes in population-based data describing treatment and survival of primary vaginal carcinoma (VC) in a routine clinical setting, stratified by age group and stage.
This nationwide, population-based study included women diagnosed with epithelial VC between 2011 and 2020, registered in the Swedish Quality Register for Gynecologic Cancer. Five-year relative survival (RS) was estimated using the Pohar Perme method. The excess mortality rate ratio (EMRR) was assessed by Poisson regression.
In total, 252 women were identified, 29% were aged ≥ 80 years. The median follow-up time was 7.5 years. The most common stages were I and II (26% each). Definitive radiotherapy, with or without chemotherapy, was administered to 59% of patients. Among women with stage I, 48% underwent primary surgery and 29% received adjuvant radiotherapy. Treatment patterns differed across age groups. Among women aged ≥ 80 years, staging was omitted in 18%, and in stage I disease 25% received palliative therapy. None of the irradiated women aged ≥ 80 years received chemoradiotherapy, compared to all women aged 20-59 years. The overall 5-year RS for stages I-IV was 51% (95% confidence interval [CI] 43-58). In stages I-II, the 5-year RS was 28% among women aged ≥80 years and 84% among those aged < 60 years (EMRR of 5.2; 95% CI 1.7-15.6).
Primary treatment of vaginal cancer in Sweden generally followed international guidelines, except among women aged ≥ 80 years. The markedly poorer RS in this age group suggests both diagnostic and therapeutic compromises.
This nationwide, population-based study included women diagnosed with epithelial VC between 2011 and 2020, registered in the Swedish Quality Register for Gynecologic Cancer. Five-year relative survival (RS) was estimated using the Pohar Perme method. The excess mortality rate ratio (EMRR) was assessed by Poisson regression.
In total, 252 women were identified, 29% were aged ≥ 80 years. The median follow-up time was 7.5 years. The most common stages were I and II (26% each). Definitive radiotherapy, with or without chemotherapy, was administered to 59% of patients. Among women with stage I, 48% underwent primary surgery and 29% received adjuvant radiotherapy. Treatment patterns differed across age groups. Among women aged ≥ 80 years, staging was omitted in 18%, and in stage I disease 25% received palliative therapy. None of the irradiated women aged ≥ 80 years received chemoradiotherapy, compared to all women aged 20-59 years. The overall 5-year RS for stages I-IV was 51% (95% confidence interval [CI] 43-58). In stages I-II, the 5-year RS was 28% among women aged ≥80 years and 84% among those aged < 60 years (EMRR of 5.2; 95% CI 1.7-15.6).
Primary treatment of vaginal cancer in Sweden generally followed international guidelines, except among women aged ≥ 80 years. The markedly poorer RS in this age group suggests both diagnostic and therapeutic compromises.
Authors
Hellman Hellman, Bjurberg Bjurberg, Borgfeldt Borgfeldt, Dahm Kähler Dahm Kähler, Flöter Rådestad Flöter Rådestad, Jönsson Jönsson, Kjølhede Kjølhede, Olsson Olsson, Sköld Sköld, Stenström Bohlin Stenström Bohlin, Stålberg Stålberg, Holmberg Holmberg, Åvall Lundqvist Åvall Lundqvist
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