Twenty years’ experience of primary vaginal cancer treatment at one cancer centre: does residence status matter?

Abstract

Objectives: To study the long-term results of the treatment of patients with vaginal cancer and to examine whether there are any differences in diagnostic and survival rates between urban and rural patients. Methods:The data of 70 patients with primary vaginal cancer treated at NN Alexandrov National Cancer Centre of Belarus from 2000 to 2019 were included. The median age was 64 years (range = 56-75). Morphology in 91.4% (64/70) of the cases was squamous cell cancer, in 7.1% (5/70) it was adenocarcinoma and in 1.4% (1/70) it was adenosquamous carcinoma. In total, there were 31 patients from urban and 39 from rural areas. The groups were comparable in age (61 versus 67, p = 0.104), morphology (p = 0.188) and distribution of stages: stage I in 7 and 10 patients (22.6% and 25.6%, respectively; p = 0.999), stage II in 14 and 16 patients (45.1% and 41.0%, respectively; p = 0.810), stage III in 6 and 6 patients (19.4% and 15.4%, respectively; p = 0.754) and stage IV in 4 and 7 patients (12.9% and 18.0%, respectively; p = 0.744). ResultsThe median follow-up time was 33 months (range = 1-220). A total of 42 women died: 28 from progression of vaginal cancer and 14 from other diseases. Overall survival (OS) was 31.9 ± 6.8%, median survival was 41 months (95% CI = 0.0-105.3). Diseasespecific survival (DSS) for the entire group was 54.5 ± 6.8%; median was not reached. The overall survival rate of urban women was 44.8 ± 10.6% and for rural it was 22.5 ± 8.2% (p = 0.142); DSS was 57.6 ± 10.5% and 53.0 ± 8.4% (p = 0.448), respectively. Conclusion DSS rate was 54.0 ± 6.8% and the OS rate did not exceed 31.9 ± 6.8%. Rural residence was not associated with late stage at diagnosis or receipt of treatment.

Malignant neoplasms of the vagina: A 30-year review from the Republic of Belarus

“…The survival outcomes from our study showed no discrepancies in survival between women living in urban and rural areas. This was also confirmed in our previous study of a single cancer center ( Matylevich et al, 2021 ). In our opinion, this is due to peculiarities of the health care system in Belarus, which is mostly provided through government-owned facilities, allowing citizens universal access to medical care, which is free at the point of use ( Richardson et al, 2013 ).…”