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Survival benefit of vaginectomy compared to local tumor excision in women with FIGO stage I and II primary vaginal carcinoma: a SEER study

  • Gynecologic Oncology
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Purpose

The effectiveness of vaginectomy compared to that of local tumor excision (LTE) for the International Federation of Gynecology and Obstetrics (FIGO) stage I and II vaginal carcinoma is unclear. We aimed to clarify if the effectiveness of vaginectomy is comparable to that of LTE in the real world.

Methods

We retrospectively evaluated data of patients with primary vaginal carcinoma registered in the Surveillance, Epidemiology, and End Results Program (SEER) database from 2004 to 2016. The multivariate Cox proportional hazards models and Fine-Gray competing risk models were used to estimate the overall survival (OS) and disease-specific survival (DSS) after propensity score matching.

Results

Of the 533 patients with FIGO stage I and II primary vaginal carcinoma, 243 and 290 patients were treated with vaginectomy and LTE, respectively. Vaginectomy was significantly associated with improved OS [unadjusted hazard ratio (HR) = 0.70, 95% confidence interval (CI) 0.53–0.95, P = 0.020; adjusted HR = 0.63, 95% CI 0.46–0.87, P = 0.005] and DSS [unadjusted subdistribution HR (sHR) = 0.75, 95% CI 0.52–1.07, P = 0.115; adjusted sHR = 0.65, 95% CI 0.44–0.97, P = 0.036]. Age, marital status, histology type, FIGO stage, chemotherapy, and lymph node metastases were significant prognostic factors of survival. Moreover, radiotherapy did not influence the effectiveness of vaginectomy. Subgroup and sensitivity analysis confirmed the consistent beneficial effectiveness of vaginectomy.

Conclusion

Compared with LTE, vaginectomy results in significantly prolonged survival in patients with FIGO stage I and II primary vaginal carcinoma. Thus, it can be the preferred treatment for FIGO I and II vaginal cancer regardless of radiotherapy status.

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Data availability

All the data analyzed in this study can be found at https://seer.cancer.gov/.

Code availability

Not applicable.

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Acknowledgements

The authors acknowledge the efforts of the SEER Program registries in the establishment of the SEER database.

Funding

None.

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Authors and Affiliations

  1. Department of General Surgery, Shengjing Hospital, China Medical University, Shenyang, China

    Weili Zhou

  2. Department of Health Management, Shengjing Hospital, China Medical University, Shenyang, China

    Yangyang Yue & Dongmei Pei

  3. Department of Family Medicine, Shengjing Hospital, China Medical University, Shenyang, China

    Dongmei Pei

Authors
  1. Weili Zhou
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  2. Yangyang Yue
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  3. Dongmei Pei
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Contributions

PD contributed to the manuscript editing and writing, project development, and supervision. YY contributed to the data analysis, manuscript editing, methodology, and software. ZW contributed to the data collection or management, manuscript editing and writing formal analyses, and project development.

Corresponding author

Correspondence to Dongmei Pei.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethics approval

This is an observational study. The Research Ethics Committee of Shengjing Hospital affiliated China Medical University has confirmed that no ethical approval is required.

Informed consent

The information was accessed from the SEER database, and the requirement for informed consent was exempted by the Review Board of Shengjing Hospital affiliated China Medical University.

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Zhou, W., Yue, Y. & Pei, D. Survival benefit of vaginectomy compared to local tumor excision in women with FIGO stage I and II primary vaginal carcinoma: a SEER study. Arch Gynecol Obstet 302, 1429–1439 (2020). https://doi.org/10.1007/s00404-020-05737-6

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  • DOI: https://doi.org/10.1007/s00404-020-05737-6

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