Exploring therapeutic aspects and prognosis of Moroccan patients with vaginal cancer: a retrospective cohort study at the University Hospital of Fez.

Abstract

Primary vaginal cancer is rare, making up 1% to 2% of all female reproductive tract cancer. In Morocco, human papillomavirus (HPV) infection is the main factor. Given its low incidence, there is no consensus on the appropriate management of this cancer. The aim of our study was to assess the global management of vaginal cancer in the Radiotherapy Department, at Hassan II University Hospital, Fez, Morocco. We conducted a retrospective study of vaginal cancer cases treated at the radiotherapy department of Hassan II University Hospital between January 2012 and December 2022. Twenty-five cases of vaginal cancer were identified during the study period. In our study series, the median age was 62 years old with a range from 34 to 81 years. The average diagnostic delay was 12 months, 88% were multiparous and the notion of risky sexual behavior has been affirmed by none of them. Out of the patients we observed, 21 had squamous cell carcinoma of the vagina, one adenocarcinoma, and 3 cases of melanoma. The primary mode of treatment for the majority of our patients was concomitant radio chemotherapy, which was administered to 21 patients. Surgery was not performed on any of the patients. In the absence of consensus in the literature on the optimal treatment, concomitant radio chemotherapy remains the standard treatment for locally advanced vaginal cancer. Currently, interests are focused on the role of HPV in the genesis of vaginal cancer and on the HPV vaccine to prevent virus-induced lesions. In fact, the emphasis should be on primary prevention with prophylactic HPV vaccination.