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Primary treatment and relative survival by stage and age in vulvar squamous cell carcinoma : A population-based SweGCG study

Hellman, Kristina ; Holmberg, Erik ; Bjurberg, Maria LU ; Borgfeldt, Christer LU ; Dahm-Kähler, Pernilla ; Flöter Rådestad, Angelique ; Hjerpe, Elisabet ; Högberg, Thomas LU ; Marcickiewicz, Janusz and Rosenberg, Per , et al. (2020) In Gynecologic Oncology 159(3). p.663-671
Abstract

Objective: Vulvar cancer affects mainly elderly women and with an ageing population the incidence has increased. We explored the primary treatment patterns and relative survival of patients with vulvar squamous cell carcinoma (VSCC) by stage and age-group. Methods: A population-based nationwide study on women diagnosed with VSCC between 2012 and 2016 and registered in the Swedish Quality Registry for Gynecologic Cancer (SQRGC). Main outcome was 5-year relative survival (RS) estimated by the Pohar Perme method. The relative risk of excess mortality (EMRR) between different groups was analyzed by Poisson regression. The age-standardized relative survival (AS-RS) was estimated for the total cohort. Results: Median follow-up time was 41... (More)

Objective: Vulvar cancer affects mainly elderly women and with an ageing population the incidence has increased. We explored the primary treatment patterns and relative survival of patients with vulvar squamous cell carcinoma (VSCC) by stage and age-group. Methods: A population-based nationwide study on women diagnosed with VSCC between 2012 and 2016 and registered in the Swedish Quality Registry for Gynecologic Cancer (SQRGC). Main outcome was 5-year relative survival (RS) estimated by the Pohar Perme method. The relative risk of excess mortality (EMRR) between different groups was analyzed by Poisson regression. The age-standardized relative survival (AS-RS) was estimated for the total cohort. Results: Median follow-up time was 41 months. The study population included 657 women; 33% were ≥ 80 years old. FIGO stage I was most common (55%). Primary surgery was performed in 96% stage I, 65% stage II, 80% stage III and 28% stage IV. In women ≥80 years, exploration of the groins and chemoradiotherapy was less often performed. They also received lower mean doses of radiation than younger women. The 5-year AS-RS was 74%. 5-year RS was 84% for stage I, 60% for stage II, 54% for stage III and 35% for stage IV. The EMRR for women ≥80 years compared with women <60 years was 4.3 (p < 0.001); 4.9 (p < 0.001) for stages I-II and 3.5(p = 0.007) for stage III. Conclusions: In general, primary treatment of patients with vulvar squamous cell carcinoma in Sweden adhered to guidelines. Areas of improvement include treatment for stage II and for the very old.

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organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Age, Stage, Survival, Treatment, Vulvar cancer
in
Gynecologic Oncology
volume
159
issue
3
pages
9 pages
publisher
Academic Press
external identifiers
  • pmid:32988623
  • scopus:85091869693
ISSN
0090-8258
DOI
10.1016/j.ygyno.2020.09.027
language
English
LU publication?
yes
id
b7270018-c003-4959-9d2f-b0ec6c4a155a
date added to LUP
2020-10-28 11:21:46
date last changed
2024-04-03 15:17:10
@article{b7270018-c003-4959-9d2f-b0ec6c4a155a,
  abstract     = {{<p>Objective: Vulvar cancer affects mainly elderly women and with an ageing population the incidence has increased. We explored the primary treatment patterns and relative survival of patients with vulvar squamous cell carcinoma (VSCC) by stage and age-group. Methods: A population-based nationwide study on women diagnosed with VSCC between 2012 and 2016 and registered in the Swedish Quality Registry for Gynecologic Cancer (SQRGC). Main outcome was 5-year relative survival (RS) estimated by the Pohar Perme method. The relative risk of excess mortality (EMRR) between different groups was analyzed by Poisson regression. The age-standardized relative survival (AS-RS) was estimated for the total cohort. Results: Median follow-up time was 41 months. The study population included 657 women; 33% were ≥ 80 years old. FIGO stage I was most common (55%). Primary surgery was performed in 96% stage I, 65% stage II, 80% stage III and 28% stage IV. In women ≥80 years, exploration of the groins and chemoradiotherapy was less often performed. They also received lower mean doses of radiation than younger women. The 5-year AS-RS was 74%. 5-year RS was 84% for stage I, 60% for stage II, 54% for stage III and 35% for stage IV. The EMRR for women ≥80 years compared with women &lt;60 years was 4.3 (p &lt; 0.001); 4.9 (p &lt; 0.001) for stages I-II and 3.5(p = 0.007) for stage III. Conclusions: In general, primary treatment of patients with vulvar squamous cell carcinoma in Sweden adhered to guidelines. Areas of improvement include treatment for stage II and for the very old.</p>}},
  author       = {{Hellman, Kristina and Holmberg, Erik and Bjurberg, Maria and Borgfeldt, Christer and Dahm-Kähler, Pernilla and Flöter Rådestad, Angelique and Hjerpe, Elisabet and Högberg, Thomas and Marcickiewicz, Janusz and Rosenberg, Per and Stålberg, Karin and Tholander, Bengt and Kjølhede, Preben and Åvall-Lundqvist, Elisabeth}},
  issn         = {{0090-8258}},
  keywords     = {{Age; Stage; Survival; Treatment; Vulvar cancer}},
  language     = {{eng}},
  month        = {{12}},
  number       = {{3}},
  pages        = {{663--671}},
  publisher    = {{Academic Press}},
  series       = {{Gynecologic Oncology}},
  title        = {{Primary treatment and relative survival by stage and age in vulvar squamous cell carcinoma : A population-based SweGCG study}},
  url          = {{http://dx.doi.org/10.1016/j.ygyno.2020.09.027}},
  doi          = {{10.1016/j.ygyno.2020.09.027}},
  volume       = {{159}},
  year         = {{2020}},
}