Prognostic Factors in Primary Vaginal Cancer: A Single Institute Experience and Review of Literature

Abstract

Background Primary vaginal carcinoma is rare, accounting for 1-2 % of all gynecological malignancies.Being rare, most observations are based on retrospective and comparative analyses. This study was aimed to retrospectively analyze the prognostic factors and its relevance in the outcomes of primary vaginal cancers.

Definitive Radiotherapy for Primary Squamous Cell Carcinoma of the Vagina: Are High-Dose External Beam Radiotherapy and High-Dose-Rate Brachytherapy Boost the Best Treatment? Experience of Two Italian Institutes

“…Some authors have used CCRT on locally advanced vaginal carcinoma, but it is still under debate whether the addition of chemotherapy leads to a clinical benefit compared to RT alone [8,[24][25][26][27]. Both Miyomoto et al [25] and Prameela et al [26] observed a significantly better prognosis for patients treated with CCRT. By contrast, Ghia et al [27] observed that the use of CCRT had increased since 1999 without any improvement in terms of disease-free survival or OS.…”

Survival and prognostic factors in primary vaginal cancer: an analysis of 2004–2014 SEER data

“…In our study, 5-year CSS for all patients was 57.8%, and 76.4% (stage I), 61.9% (stage II), 53.3% (stage III) and 22.5% (stage IV). Major predictors of clinical outcome could be grouped as patients’ factors (performance status, older age, tobacco use, comorbidities, HPV-status, race, status of uterus) ( 5 , 11 , 12 , 23 , 26 - 29 ); tumor factors (disease stage, tumor size, histological type, pelvic lymph node metastasis, tumor site, grade of differentiation) ( 5 , 12 , 14 , 23 , 26 , 27 ); and treatment parameters (lymphadenectomy, brachytherapy utilization, concurrent chemoradiotherapy, higher facility volume, surgery, radiation dose, chemotherapy status) ( 11 , 14 , 15 , 25 , 29 , 30 ). Based on our univariate analysis results, age, marital status, race, pathological grade, histology, TNM stage, tumor size, surgery and radiation were related to prognosis.…”

“…Hiniker et al reported that stage was the single best indicator of prognosis ( 31 ). A recent study showed that not only overall survival (OS), but also disease-free survival (DFS) and CSS for each stage of PVC were significant correlated with stage ( 12 ). In our study, compared with women with stage I disease, patients with stage II, stage III and stage IV disease had elevated mortality risks (HR: 1.77, 2.28 and 5.43, respectively).…”

“…Surgery and radiation are the main treatments for vaginal cancer (9,10). Previous studies have indicated that the dominant prognostic factors for PVC include age, histological type, grade of differentiation, stage, tumor size, tumor site, surgery, radiation and chemotherapy (5,(11)(12)(13)(14)(15). Although some recent studies have shown marital status to be an independent predictor of survival in various gynecologic cancers, with married women enjoying longer survival and lower mortality than widows and single women (16)(17)(18)(19), the effect of marital status on PVC prognosis had not, to our knowledge, been specially studied.…”

“…Multivariate analysis suggested that age, histology, TNM stage, tumor size, surgery and radiation were independent prognostic factors.Notably, our study confirms the results of various prior reports that have evaluated prognostic factors for PVC, lending credence to our findings. Stage is recognized as the most important determinant of prognosis for patients with PVC(9,11,12,14,23,27). Higher stage may be associated with more comorbidities, or decreased odds of surgery or lower radiation dose, and would therefore lead to poorer survival.…”