Survival benefit of vaginectomy compared to local tumor excision in women with FIGO stage I and II primary vaginal carcinoma: a SEER study
| Autor: | Wei-li Zhou, Dong-mei Pei, Yang-yang Yue |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Vaginal cancer 030219 obstetrics & reproductive medicine Proportional hazards model business.industry medicine.medical_treatment Hazard ratio Urology Obstetrics and Gynecology Vaginectomy General Medicine medicine.disease Confidence interval Radiation therapy 03 medical and health sciences 0302 clinical medicine 030220 oncology & carcinogenesis Propensity score matching medicine Stage (cooking) business |
| Zdroj: | Archives of Gynecology and Obstetrics. 302:1429-1439 |
| ISSN: | 1432-0711 0932-0067 |
| DOI: | 10.1007/s00404-020-05737-6 |
| Popis: | 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. 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. 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. 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. |
| Databáze: | OpenAIRE |
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