ABSTRACT
Objective: To perform a retrospective review of patients diagnosed with vaginal malignant neoplasms (VMN) in the Republic of Belarus. Methods: The Belarusian Cancer Registry was reviewed for patients diagnosed with VMN from 1990 to 2019. The data collected included age at diagnosis, demographic information, histology, stage, treatment modalities, and outcomes. Data were compared across decades (1990-1999, 2000-2009, and 2010-2019). Results: A total of 868 patients were diagnosed with VMN in Belarus between 1990 and 2019. The estimated age-standardized incidence rate of VMN per 100,000 female population increased from 0.1 in 1999 to 0.4 in 2019 (p < 0.05). The mortality rate for this period was 0.0-0.2 per 100,000 female population. Of all newly diagnosed cases of VMN, 70.9% (n = 615) lived in urban centers and 29.1% (n = 253) lived in rural areas. The most common histological type was squamous cell carcinoma, accounting for 78.4% of cases. The median age at diagnosis was 63.4 years (range, 15.0-87.0 years). When compared across the three decades, the number of stage I cases increased slightly more than twofold (from 19.1% to 38.5% for 1990-1999 to 2010-2019). Furthermore, the number of stage III cases decreased from 30.3% to 13.0% from 1990 to 1999 to 2010-2019. There were no significant changes in the number of patients diagnosed with stage II or IV disease over time. The overall 5-year survival rate for the entire group was 68.7 ± 5.1%, with no statistically significant difference between women living in urban centers vs. rural areas (67.8 ± 5.1% vs. 65.8 ± 10.4%; p = 0.99). However, there was a 26.2% increase in the 5-year survival rate for the entire group over the study period. This increase was higher for women living in rural areas (+61.7%) than for those in urban centers (+51.3%); p > 0.05. Furthermore, a comparison of 5-year adjusted survival rates between 2000 and 2015 showed increased survival for stages I, II, and III, with the most significant increase noted for stage III disease (2.4-fold increase). Conclusions: This retrospective study found that the survival rates of women with VMN in Belarus have improved over the past 30 years. This is likely due to improvements in early detection as well as improved approaches to treatment, particularly for those living in rural areas. Additional study is needed to further understand and improve the outcomes of women diagnosed with VMN in Belarus.
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). RESULTS: The 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). Disease-specific 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.
