Survival Outcome of Patients with Vaginal Malignancy: A 10-year Cohort Study from Tertiary Care Centre, Southern India

Introduction: Vaginal malignancy is a rare gynaecological malignancy, and authors know little about its survival and prognostic factors. The management of vaginal malignancies is largely determined by factors such as histological type, tumor size, anatomical site, disease stage, and patient age. Available treatment approaches include surgery, radiotherapy, chemotherapy, or a combination of these modalities. Aim: To determine the survival outcomes of patients with vaginal malignancy treated at a tertiary cancer centre. Materials and Methods: A retrospective cohort study was conducted in the Department of Oncology, Malabar Cancer Centre (Postgraduate Institute of Oncology Sciences and Research), Thalassery, Kerala, India. a period of 10 years, from January 2010 to December 2019, at a South Indian tertiary cancer centre. A total of 49 patients with primary vaginal malignancy were registered at the hospital, and their data were retrospectively reviewed from the medical records department. After treatment completion, patients were followedup every three months for the first two years, every six months for the next three years, and annually thereafter. The primary endpoints were Overall Survival (OS) and Diseasefree Survival (DFS), which were analysed using Kaplan-Meier analysis. Results: There were a total of 49 patients with primary vaginal malignancy, of which 28 patients received curative treatment, 18 patients received palliative care, and 3 patients with poor performance status were given best supportive care. Squamous cell carcinoma was the most common histology, accounting for 44 (89.8%) cases. The median follow-up period was 139.9 months. The five-year overall survival rate was 54.8%. For patients with curative intent, the five-year overall survival rate was 67.9%, while for palliative patients, it was 25.4%. For curative patients, the two-year OS was 85.7%, and for palliative patients, it was 77.8%. The five-year DFS among curative intent patients was 84.2%, and the two-year DFS was 88.9%. Conclusion: Curative treatment significantly improved survival outcomes compared to palliative care in patients with vaginal malignancies. Early diagnosis in lower stages and preventive measures are also necessary for increasing the survival rate. Given the scarcity of large-scale data on vaginal cancers, this study adds valuable regional evidence to the global understanding of this rare malignancy and underscores the need for continued research and awareness.