title: Comparing mortality of vaginal sarcoma, squamous cell carcinoma, and adenocarcinoma in the surveillance, epidemiology, and end results database.
abstract: OBJECTIVE
  To evaluate the mortality outcomes of vaginal sarcomas in a large cohort compared with vaginal squamous cell and adenocarcinomas.
  
  
  METHODS
  Women with primary invasive vaginal sarcomas, squamous cell carcinomas, and adenocarcinomas diagnosed between 1988 and 2010 were identified within the National Cancer Institute's Surveillance, Epidemiology, and End Results database. Parametric and nonparametric methods were used to compare the demographic and clinical characteristics of women among the three tumor types as well as between sarcoma histologic subtypes. Overall and cancer-specific mortality outcomes were examined using Kaplan-Meier and multivariable Cox proportional hazards models.
  
  
  RESULTS
  The final cohort consisted of 3,121 patients with vaginal squamous cell carcinoma, 720 patients with adenocarcinoma, and 221 patients with sarcoma. Compared with women with squamous cell carcinoma and adenocarcinoma, patients diagnosed with vaginal sarcomas tended to be younger, have larger tumors with less regional extension and lymph node positivity, and be treated primarily with surgery without radiation. In unadjusted analysis, 5-year mortality rates border 30% for all three histologies. After adjusting for other prognostic factors including use of radiation and surgery, patients with vaginal sarcomas had a 69% greater risk of cancer-related mortality compared with patients with squamous cell carcinoma (hazard ratio 1.69, 95% confidence interval 1.26-2.26). Although sarcoma histology failed to associate with mortality risk, age, tumor extension and metastasis, and surgery were poor prognostic factors.
  
  
  CONCLUSIONS
  Primary vaginal sarcomas are aggressive neoplasms with different presenting characteristics and increased adjusted risk of mortality compared with squamous cell and adenocarcinoma subtypes.
  
  
  METHODS
  III.
authors.affiliation: Harvard T. H. Chan School of Public Health and the Division of Gynecologic Oncology, Vincent Obstetrics and Gynecology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts; and the University of California, San Francisco School of Medicine, San Francisco, California.
authors.forename: Talayeh
authors.initials: T
authors.lastname: Ghezelayagh
authors.forename: Jose Alejandro
authors.initials: JA
authors.lastname: Rauh-Hain
authors.forename: Whitfield B
authors.initials: WB
authors.lastname: Growdon
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D002423:Cause of Death; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D053208:Kaplan-Meier Estimate; D008207:Lymphatic Metastasis; D008875:Middle Aged; D016016:Proportional Hazards Models; D018426:SEER Program; D012509:Sarcoma / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D015996:Survival Rate; D014481:United States / Q000453:epidemiology; D014625:Vaginal Neoplasms / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D055815:Young Adult