Yagi Asami, Ueda Yutaka, Kakuda Mamoru, Tanaka Yusuke, Egawa-Takata Tomomi, Morimoto Akiko, Iwamiya Tadashi, Matsuzaki Shinya, Kobayashi Eiji, Yoshino Kiyoshi, Fukui Keisuke, Ito Yuri, Nakayama Tomio, Kimura Tadashi
Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine Center for Cancer Control and Statistics, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan.
Medicine (Baltimore). 2017 Aug;96(32):e7751. doi: 10.1097/MD.0000000000007751.
Vaginal cancer is such a rare tumor that epidemiological and clinical information for it is based mainly on studies of small numbers of cases. The aim of the present study was to perform a descriptive epidemiological analysis of vaginal cancer using a significantly larger population-based dataset from the Japanese Osaka Cancer Registry.The age-standardized incidence of vaginal cancer per 1,000,000 persons, from 1976 to 2010, was calculated and examined for trends. Relative-survival analysis was applied to estimate a more up-to-date 10-year period calculation, using data from recently followed-up patients. The conditional 5-year survival of patients who survived for 0 to 5 years after diagnosis was calculated.A total of 481 cases of vaginal cancer were registered in Osaka during the 35-year period from 1976 to 2010. The age-adjusted incidence rate has significantly and consistently decreased over this time [annual percent change (APC) = -1.29, 95% confidence interval (95% CI): -0.3 ∼ -2.2]; however, due to significant population aging, the raw incidence of vaginal cancer appeared to have been increasing. The 10-year relative survival of patients with surgery-based treatments was comparable to that of radiation-based treatments, implying that surgery and radiotherapy provide similar therapeutic benefits (P = .98). The 10-year relative survival was not significantly different during the period of 1976 to 2000 compared with the period of 2001 to 2008, although there has been, in the latter period, a tendency for improvement of long-term survival, especially for survival longer than 5 years. The longer the time after diagnosis, the higher the conditional 5-year relative-survival at 0 to 4 years after diagnosis.The age-adjusted incidence of vaginal cancer has decreased since 1976. Regrettably, the 10-year survival rate did not similarly improve, and it remained stable during the period from 2001 to 2008, compared with the period from 1976 to 2000, indicating that significant work remains to be done to develop more effective vaginal cancer treatments.
阴道癌是一种极为罕见的肿瘤，其流行病学和临床信息主要基于对少量病例的研究。本研究的目的是利用来自日本大阪癌症登记处的一个规模显著更大的基于人群的数据集，对阴道癌进行描述性流行病学分析。计算了1976年至2010年每100万人中阴道癌的年龄标准化发病率，并对其趋势进行了研究。采用相对生存分析，利用最近随访患者的数据来估计更近期的10年期间的计算结果。计算了诊断后存活0至5年的患者的条件性5年生存率。
在1976年至2010年的35年期间，大阪共登记了481例阴道癌病例。在此期间，年龄调整后的发病率显著且持续下降[年变化百分比(APC)= -1.29，95%置信区间(95%CI)：-0.3 ∼ -2.2]；然而，由于人口显著老龄化，阴道癌的粗发病率似乎一直在上升。接受手术治疗的患者的10年相对生存率与接受放射治疗的患者相当，这意味着手术和放疗提供了相似的治疗效果(P = 0.98)。与2001年至2008年期间相比，1976年至2000年期间的10年相对生存率没有显著差异，尽管在后一时期，长期生存率有改善的趋势，尤其是生存超过5年的情况。诊断后的时间越长，诊断后0至4年的条件性5年相对生存率越高。
自1976年以来，阴道癌的年龄调整发病率有所下降。遗憾的是，10年生存率没有类似的提高，与1976年至2000年期间相比，2001年至2008年期间保持稳定，这表明在开发更有效的阴道癌治疗方法方面仍有大量工作要做。
