Bucchi L, Giudici F, Toffolutti F, De Paoli A, Mancini S, Preti M, Gatta G, Ferretti S, Crocetti E, Fiore AR, Bidoli E, Caldarella A, Falcini F, Gili A, Cuccaro F, Gambino ML, Casella C, Cavallo R, Ferrante M, Migliore E, Carrozzi G, Musolino A, Mazzucco W, Gasparotti C, Fusco M, Ballotari P, Sampietro G, Mangone L, Mantovani W, Cascone G, Mian M, Manzoni F, Pesce MT, Galasso R, Bella F, Seghini P, Fanetti AC, Piras D, Pinna P, Serraino D, Guzzinati S, Dal Maso L; AIRTUM Working Group.
Eur J Surg Oncol. 2024 Sep 26:108707. doi: 10.1016/j.ejso.2024.108707. Online ahead of print.
Abstract
Objective: Five-year net survival and conditional survival from vulvar squamous cell carcinoma (VSCC) patients in Italy have shown no progress during the past three decades. This study aims to estimate the complete prevalence and multiple indicators of cure.
Methods: Observed prevalence was estimated using 31 Italian cancer registries covering 47 % of Italian women. A subset of 22 cancer registries was used to estimate model-based long-term survival and indicators of cure, i.e., complete prevalence, cure fraction (CF), time to cure (TTC), proportion of ‘already cured’ patients, and cure prevalence.
Results: In 2018, VSCC patients alive in Italy (complete prevalence) were 6620 or 22 per 100,000 women. The cure fraction (the proportion of newly diagnosed patients who will not die of VSCC) did not change between 2000 and 2010 both for all patients (32 %) and in each age group. The time to cure (5-year conditional net survival >95 %) was 11 years for patients aged ≥44 years, but excess mortality remained for >15 years in the other age groups. This led to a negligible (5 %) proportion of ‘already cured’ patients (living longer than time to cure). The proportion of patients alive <2 years (21 %) was the same as that of patients surviving ≥15 years. The cure prevalence (patients who will not die of VSCC) was 64 %. A considerable proportion of patients will not be cured even among those who survived ≥5 years.
Conclusion: There is an urgent need to reshape the current vulvar care model in Italy.