Mancini Silvia, Bucchi Lauro, Zamagni Federica, Baldacchini Flavia, Crocetti Emanuele, Giuliani Orietta, Ravaioli Alessandra, Vattiato Rosa, Preti Mario, Tumino Rosario, Ferretti Stefano, Biggeri Annibale, Ballotari Paola, Boschetti Lorenza, Brustolin Angelita, Caldarella Adele, Cavallo Rossella, Cirilli Claudia, Citarella Annarita, Contrino Maria L, Dal Maso Luigino, Filiberti Rosa A, Fusco Mario, Galasso Rocco, Lotti Fernanda L, Magoni Michele, Mangone Lucia, Masanotti Giuseppe, Mazzoleni Guido, Mazzucco Walter, Melcarne Anna, Michiara Maria, Pesce Paola, Pinto Angela, Piras Daniela, Rizzello Roberto V, Rognoni Magda, Rosso Stefano, Rugge Massimo, Sampietro Giuseppe, Scalzi Santo, Scuderi Tiziana, Tagliabue Giovanna, Toffolutti Federica, Vitarelli Susanna, Falcini Fabio
Romagna Cancer Registry, Romagna Cancer Institute (IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) Dino Amadori), 47014 Meldola, Italy.
Department of Obstetrics and Gynaecology, University of Torino, 10124 Torino, Italy.
J Clin Med. 2023 Mar 10;12(6):2172. doi: 10.3390/jcm12062172.
(1) Objective: In many Western countries, survival from vulvar squamous cell carcinoma (VSCC) has been stagnating for decades or has increased insufficiently from a clinical perspective. In Italy, previous studies on cancer survival have not taken vulvar cancer into consideration or have pooled patients with vulvar and vaginal cancer. To bridge this knowledge gap, we report the trend in survival from vulvar cancer between 1990 and 2015. (2) Methods: Thirty-eight local cancer registries covering 49% of the national female population contributed the records of 6274 patients. Study endpoints included 1- and 2-year net survival (NS) calculated using the Pohar-Perme estimator and 5-year NS conditional on having survived two years (5|2-year CNS). The significance of survival trends was assessed with the Wald test on the coefficient of the period of diagnosis, entered as a continuous regressor in a Poisson regression model. (3) Results: The median patient age was stable at 76 years. One-year NS decreased from 83.9% in 1990-2001 to 81.9% in 2009-2015 and 2-year NS from 72.2% to 70.5%. Five|2-year CNS increased from 85.7% to 86.7%. These trends were not significant. In the age stratum 70-79 years, a weakly significant decrease in 2-year NS from 71.4% to 65.7% occurred. Multivariate analysis adjusting for age group at diagnosis and geographic area showed an excess risk of death at 5|2-years, of borderline significance, in 2003-2015 versus 1990-2002. (4) Conclusions: One- and 2-year NS and 5|2-year CNS showed no improvements. Current strategies for VSCC control need to be revised both in Italy and at the global level.
（1）目的：在许多西方国家，外阴鳞状细胞癌（VSCC）的生存率数十年来一直停滞不前，或者从临床角度来看增长不足。在意大利，以往关于癌症生存率的研究未将外阴癌纳入考虑范围，或者将外阴癌和阴道癌患者合并统计。为填补这一知识空白，我们报告了1990年至2015年期间外阴癌的生存趋势。（2）方法：38个覆盖全国49%女性人口的地方癌症登记处提供了6274例患者的记录。研究终点包括使用波哈尔-佩尔梅估计器计算的1年和2年净生存率（NS）以及以存活两年为条件的5年NS（5|2年CNS）。生存趋势的显著性通过对诊断时期系数进行Wald检验来评估，该系数作为连续回归变量纳入泊松回归模型。（3）结果：患者年龄中位数稳定在76岁。1年NS从1990 - 2001年的83.9%降至2009 - 2015年的81.9%，2年NS从72.2%降至70.5%。5|2年CNS从85.7%升至86.7%。这些趋势均无显著性。在70 - 79岁年龄组中，2年NS从7
