title: Prognostic impact of clinical tumor size on overall survival for subclassifying stages I and II vaginal cancer: A SEER analysis.
abstract: This study accessed the Surveillance, Epidemiology and End Results (SEER) database to determine if tumor size is an independent predictor of overall survival (OS) for patients with stages I and II vaginal cancer (VC).
  
  
  
  We identified in the SEER database, patients with available tumor size having stage I or II squamous cell histology from January 2004 through December 2012 with minimum follow-up of six months. Univariate analyses (UA) and multivariable analyses (MVA) evaluated the effect of several prognostic factors, including tumor size, regarding OS.
  
  
  
  529 SEER patients were found with recorded tumor sizes, of which 293 (55.4%) were stage I and 236 (44.6%) stage II. UA found the following significant prognostic factors of worse OS: tumor size >2cm (HR=1.80, p=0.02) and older age at diagnosis (p<0.001) in stage I; and tumor size >2cm (HR=2.13, p=0.04) and older age at diagnosis (p<0.001) in stage II. Estimates of 5-year OS in patients with tumor size ≤2cm vs. >2cm were 79.2% vs. 66.1% in stage I (p=0.0187) and 80.9% vs. 51.2% in stage II (p=0.0369). MVA confirmed about double risk of death for patients with tumor size >2cm (HRs: 1.88 in stage I and 2.06 in stage II).
  
  
  
  Tumor size seems to predict OS outcome in patients with stages I/II VC. Further confirmatory investigations are recommended to firmly establish its incorporation into currently accepted staging criteria for these patients.
authors.affiliation: Department of Radiation Oncology, University of Miami Miller School of Medicine, Miami, FL, United States. Electronic address: awolfson@med.miami.edu.
authors.forename: Aaron H
authors.initials: AH
authors.lastname: Wolfson
authors.affiliation: Division of Biostatistics, Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, United States; Biostatistics and Bioinformatics Core Shared Resource, Sylvester Comprehensive Cancer Center, University of Miami School of Medicine, Miami, FL, United States.
authors.forename: Isildinha M
authors.initials: IM
authors.lastname: Reis
authors.affiliation: Department of Radiation Oncology, University of Miami Miller School of Medicine, Miami, FL, United States.
authors.forename: Lorraine
authors.initials: L
authors.lastname: Portelance
authors.affiliation: Department of Radiation Oncology, Ohio State University, Columbus, OH, United States.
authors.forename: Dayssy A
authors.initials: DA
authors.lastname: Diaz
authors.affiliation: Biostatistics and Bioinformatics Core Shared Resource, Sylvester Comprehensive Cancer Center, University of Miami School of Medicine, Miami, FL, United States.
authors.forename: Wei
authors.initials: W
authors.lastname: Zhao
authors.affiliation: Gynecologic Oncology, Billings Clinic, Billings, MT, United States.
authors.forename: Randall K
authors.initials: RK
authors.lastname: Gibb
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008875:Middle Aged; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D011379:Prognosis; D018426:SEER Program; D015996:Survival Rate; D014481:United States / Q000453:epidemiology; D014625:Vaginal Neoplasms / Q000401:mortality* / Q000473:pathology*
keywords: Prognostic factors; SEER analyses; Staging criteria; Tumor size; Vaginal cancer