Clinical characteristics, treatment patterns, and prognosis in vulvar cancer and vaginal cancer - a national multicenter retrospective study in China

Q: What is the main purpose of this study?

To characterize HPV prevalence, clinicopathological features, treatment patterns, and survival outcomes for vulvar and vaginal cancers in China, and to assess how these factors relate to each other.

Q: How were survival outcomes analyzed?

Overall survival and disease-free survival were assessed using the Kaplan-Meier method, with multivariable Cox proportional hazards regression for evaluating associations.

Q: What treatment difference was most notable between vulvar and vaginal cancer?

Receiving surgery during the primary treatment phase was much more common in vulvar cancer than in vaginal cancer, and it was associated with longer overall and disease-free survival for vulvar cancer.

Sep 22, 2026

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Retrospective multicenter data from nine tertiary hospitals in China evaluated HPV prevalence, clinicopathological features, treatment patterns, and survival outcomes for vulvar and vaginal cancers. Patients diagnosed and treated between 2017 and 2021 were analyzed using Wilcoxon rank-sum, chi-square/Fisher’s exact tests, Kaplan-Meier estimates, and multivariable Cox regression. Among 218 patients, HPV infection was higher in vaginal than vulvar cancer, while both cancers were mainly early-stage, with distinct differentiation profiles. Surgery in primary treatment was common for vulvar cancer and linked to better overall and disease-free survival, unlike vaginal cancer, where treatment varied. HPV status showed limited prognostic relevance for vulvar cancer.

LanguageEnglish

CategoryResearch & Report

FormatPDF

Pages12

Reading Time30 min

AccessFree to download

Background

HPV infection and genital cancers

Need for China-specific evidence

Methods

Study design and setting

Data collection and statistical analyses

Survival evaluation

Results

Patient characteristics and HPV prevalence

Stage and histological differentiation

Treatment patterns and survival associations

Conclusions

Zhao et al. BMC Public Health (2026) 26:1831 BMC Public Health [https://doi.org/10.1186/s12889-026-27384-3](https://doi.org/10.1186/s12889-026-27384-3) RESEARCH Open Access Clinical characteristics, treatment patterns, and prognosis in vulvar cancer and vaginal cancer: a national multicenter retrospective study in China Xuelian Zhao1†, Honghao Wang1†, Yuting Hong1†, Qiaoyun Du2, Yuanyuan Zhang3, Shangying Hu 1, Meiwen Yuan1, Hongying Yang4, Yan Wang5, Xiaoli Cui6, Yongzhen Zhang7, Shaokai Zhang8, Wenjun Wang9, Guang Han 10, Li Li 11, Chao Ding12* and Fanghui Zhao1* Abstract Background Vulvar and vaginal cancers significantly impact women’s health and quality of life. This study analyzes the prevalence of human papillomavirus (HPV), clinicopathological characteristics, treatment patterns, and survival outcomes, to understand their relationships and better guide prevention and therapy for Chinese patients with vulvar or vaginal cancer. Methods We conducted a retrospective, multicenter study across nine tertiary hospitals located in seven regions of China, including patients diagnosed and treated between 2017 and 2021. Data were collected from medical records and standardized questionnaires, with routine clinical follow-up. Continuous variables were analyzed using the Wilcoxon rank-sum test, while categorical variables were compared using the chi-square test or Fisher’s exact test, as appropriate. Survival outcomes, including overall survival and disease-free survival, were evaluated using the KaplanMeier method and multivariable cox proportional hazards regression. Results A total of 218 patients (131 vulvar, 87 vaginal) were analyzed. HPV infection was significantly higher in vaginal than vulvar cancer (76 . 1% vs. 33. 8%, p < 0. 001) . A non-significant trend toward younger age at diagnosis has been observed in HPV-positive vulvar cancer patients (p = 0 . 072) . Both vulvar and vaginal cancers were predominantly earlystage (FIGO I: 57 . 3% vs. 51. 7%), but vulvar tumors were more often well-differentiated (46 . 7%), while vaginal cancers were mainly moderately (39 . 2%) or poorly differentiated (23 . 5%) . Receiving surgery during primary treatment phase was more common in vulvar cancer (84 . 6% vs. 50. 6%, p < 0. 001), often without adjuvant therapy (p = 0 . 016) . Primary surgery was associated with longer overall survival and disease-free survival in vulvar cancer (p < 0. 001), but not in †Xuelian Zhao, Honghao Wang andYuting Hong contributed equally to this work. *Correspondence: Chao Ding [superdingchao@126.com](superdingchao@126.com)[ ](superdingchao@126.com)Fanghui Zhao [zhaofangh@cicams.ac.cn](zhaofangh@cicams.ac.cn) Full list of author information is available at the end of the article © The Author(s) 2026. Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit [http://creati](http://creati)[vecommons.org/licenses/by-nc-nd/4.0/](vecommons.org/licenses/by-nc-nd/4.0/.)[.](vecommons.org/licenses/by-nc-nd/4.0/.) Zhao et al. BMC Public Health (2026) 26:1831 Page 2 of 12 vaginal cancer. A non-si

FAQs

What is the main purpose of this study?

To characterize HPV prevalence, clinicopathological features, treatment patterns, and survival outcomes for vulvar and vaginal cancers in China, and to assess how these factors relate to each other.

How were survival outcomes analyzed?

Overall survival and disease-free survival were assessed using the Kaplan-Meier method, with multivariable Cox proportional hazards regression for evaluating associations.

What treatment difference was most notable between vulvar and vaginal cancer?

Receiving surgery during the primary treatment phase was much more common in vulvar cancer than in vaginal cancer, and it was associated with longer overall and disease-free survival for vulvar cancer.

Sep 22, 2026

Upload by Miles