Survival and prognostic factors in vaginal cancer: an analysis of 2016-2020 nationwide data

Vaginal cancer is a rare gynecological malignant disease. In Japan, the proportion of vaginal cancer cases is estimated to increase as the population ages. The purpose of this study is to evaluate the age-specific incidence, treatment options, and prognosis of vaginal cancer in Japan.

This retrospective observational study used the Japan Society of Obstetrics and Gynecology tumor registry database. Patient characteristics included age, year diagnosed with vaginal cancer (2016-2020), and cancer stages, histological types, and treatment methods. The 2016 and 2017 dataset included follow-up time, survival status, and cause of death.

A total of 746 patients were diagnosed with vaginal cancer from 2016 to 2020. The median age of the patients was 72 years. Radiotherapy was most chosen as the primary treatment option for all ages and stages. Surgery was selected mostly in stage I and II (n = 118, 22.2% of these stage patients). Five-year overall survival for stages I, II, III, and IV was 87.6%, 55.6%, 59.9%, and 15.3%, respectively. Multivariate analysis showed that 3 year OS was significantly better for patients who underwent surgery than those who received chemotherapy (HR 3.11, P = 0.00389) and those who received radiation therapy (HR 2.89, P = 0.0241), but not compared with concurrent chemoradiotherapy (HR 1.21, P = 0.7091). Histological type did not significantly affect prognosis. For stages I and II, surgery resulted in a better prognosis than radiation (P = 0.03).

Radiation therapy is the primary treatment for vaginal cancer; however, surgery may be an effective option in early-stage vaginal cancer when cases are appropriately selected.