{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,30]],"date-time":"2026-03-30T18:39:12Z","timestamp":1774895952466,"version":"3.50.1"},"reference-count":62,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2023,3,10]],"date-time":"2023-03-10T00:00:00Z","timestamp":1678406400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003196","name":"Italian Ministry of Health","doi-asserted-by":"publisher","award":["Wfn101L1"],"award-info":[{"award-number":["Wfn101L1"]}],"id":[{"id":"10.13039\/501100003196","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>(1) Objective: In many Western countries, survival from vulvar squamous cell carcinoma (VSCC) has been stagnating for decades or has increased insufficiently from a clinical perspective. In Italy, previous studies on cancer survival have not taken vulvar cancer into consideration or have pooled patients with vulvar and vaginal cancer. To bridge this knowledge gap, we report the trend in survival from vulvar cancer between 1990 and 2015. (2) Methods: Thirty-eight local cancer registries covering 49% of the national female population contributed the records of 6274 patients. Study endpoints included 1- and 2-year net survival (NS) calculated using the Pohar-Perme estimator and 5-year NS conditional on having survived two years (5|2-year CNS). The significance of survival trends was assessed with the Wald test on the coefficient of the period of diagnosis, entered as a continuous regressor in a Poisson regression model. (3) Results: The median patient age was stable at 76 years. One-year NS decreased from 83.9% in 1990\u20132001 to 81.9% in 2009\u20132015 and 2-year NS from 72.2% to 70.5%. Five|2-year CNS increased from 85.7% to 86.7%. These trends were not significant. In the age stratum 70\u201379 years, a weakly significant decrease in 2-year NS from 71.4% to 65.7% occurred. Multivariate analysis adjusting for age group at diagnosis and geographic area showed an excess risk of death at 5|2-years, of borderline significance, in 2003\u20132015 versus 1990\u20132002. (4) Conclusions: One- and 2-year NS and 5|2-year CNS showed no improvements. Current strategies for VSCC control need to be revised both in Italy and at the global level.<\/jats:p>","DOI":"10.3390\/jcm12062172","type":"journal-article","created":{"date-parts":[[2023,3,13]],"date-time":"2023-03-13T03:03:57Z","timestamp":1678676637000},"page":"2172","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Trends in Net Survival from Vulvar Squamous Cell Carcinoma in Italy (1990\u20132015)"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0673-3347","authenticated-orcid":false,"given":"Silvia","family":"Mancini","sequence":"first","affiliation":[{"name":"Romagna Cancer Registry, Romagna Cancer Institute (IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) Dino Amadori), 47014 Meldola, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6771-8119","authenticated-orcid":false,"given":"Lauro","family":"Bucchi","sequence":"additional","affiliation":[{"name":"Romagna Cancer Registry, Romagna Cancer Institute (IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) Dino Amadori), 47014 Meldola, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6129-6656","authenticated-orcid":false,"given":"Federica","family":"Zamagni","sequence":"additional","affiliation":[{"name":"Romagna Cancer Registry, Romagna Cancer Institute (IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) Dino Amadori), 47014 Meldola, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Flavia","family":"Baldacchini","sequence":"additional","affiliation":[{"name":"Romagna Cancer Registry, Romagna Cancer Institute (IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) Dino Amadori), 47014 Meldola, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emanuele","family":"Crocetti","sequence":"additional","affiliation":[{"name":"Romagna Cancer Registry, Romagna Cancer Institute (IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) Dino Amadori), 47014 Meldola, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Orietta","family":"Giuliani","sequence":"additional","affiliation":[{"name":"Romagna Cancer Registry, Romagna Cancer Institute (IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) Dino Amadori), 47014 Meldola, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8778-6397","authenticated-orcid":false,"given":"Alessandra","family":"Ravaioli","sequence":"additional","affiliation":[{"name":"Romagna Cancer Registry, Romagna Cancer Institute (IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) Dino Amadori), 47014 Meldola, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rosa","family":"Vattiato","sequence":"additional","affiliation":[{"name":"Romagna Cancer Registry, Romagna Cancer Institute (IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) Dino Amadori), 47014 Meldola, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1573-3114","authenticated-orcid":false,"given":"Mario","family":"Preti","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, University of Torino, 10124 Torino, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2666-414X","authenticated-orcid":false,"given":"Rosario","family":"Tumino","sequence":"additional","affiliation":[{"name":"Cancer Registry and Histopathology Department, Provincial Health Authority (ASP), 97100 Ragusa, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5241-2101","authenticated-orcid":false,"given":"Stefano","family":"Ferretti","sequence":"additional","affiliation":[{"name":"Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Local Health Authority, 44121 Ferrara, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Annibale","family":"Biggeri","sequence":"additional","affiliation":[{"name":"Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, 35128 Padua, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4057-3535","authenticated-orcid":false,"given":"Paola","family":"Ballotari","sequence":"additional","affiliation":[{"name":"Mantova & Cremona Cancer Registry, Epidemiology Unit, Val Padana Health Protection Agency, 46100 Mantova, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lorenza","family":"Boschetti","sequence":"additional","affiliation":[{"name":"Pavia Cancer Registry, Public Health Agency of Pavia, 27100 Pavia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Angelita","family":"Brustolin","sequence":"additional","affiliation":[{"name":"Unit of Epidemiology and Cancer Registry, Local Health Authority, 01100 Viterbo, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adele","family":"Caldarella","sequence":"additional","affiliation":[{"name":"Tuscany Cancer Registry, Clinical and Descriptive Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network (ISPRO), 50139 Florence, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rossella","family":"Cavallo","sequence":"additional","affiliation":[{"name":"Cancer Registry of Local Health Authority Salerno, 84124 Salerno, 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(CRO) IRCCS, 33081 Aviano, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4682-393X","authenticated-orcid":false,"given":"Rosa A.","family":"Filiberti","sequence":"additional","affiliation":[{"name":"Liguria Cancer Registry, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mario","family":"Fusco","sequence":"additional","affiliation":[{"name":"Napoli 3 Sud Cancer Registry, 80031 Napoli, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4831-6437","authenticated-orcid":false,"given":"Rocco","family":"Galasso","sequence":"additional","affiliation":[{"name":"Unit of Regional Cancer Registry, Clinical Epidemiology and Biostatistics, IRCCS-CROB, Basilicata, 85028 Rionero in Vulture, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fernanda 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Register, Department of Experimental Medicine, University of Perugia, 06123 Perugia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Guido","family":"Mazzoleni","sequence":"additional","affiliation":[{"name":"South Tyrol Tumor Registry, 39100 Bolzano, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5090-1366","authenticated-orcid":false,"given":"Walter","family":"Mazzucco","sequence":"additional","affiliation":[{"name":"Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, 90131 Palermo, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna","family":"Melcarne","sequence":"additional","affiliation":[{"name":"Lecce Province Cancer Registry, 73100 Lecce, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria","family":"Michiara","sequence":"additional","affiliation":[{"name":"Parma Cancer 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Citt\u00e0 della Salute e della Scienza di Torino, 10123 Turin, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Massimo","family":"Rugge","sequence":"additional","affiliation":[{"name":"Veneto Tumour Registry, Azienda Zero, University of Padova-DIMED, 35132 Padova, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giuseppe","family":"Sampietro","sequence":"additional","affiliation":[{"name":"Bergamo Cancer Registry, ATS Bergamo, 24121 Bergamo, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Santo","family":"Scalzi","sequence":"additional","affiliation":[{"name":"Catanzaro ASP Cancer Registry, 88100 Catanzaro, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tiziana","family":"Scuderi","sequence":"additional","affiliation":[{"name":"Trapani and Agrigento Cancer Registry, 91100 Trapani, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8165-5524","authenticated-orcid":false,"given":"Giovanna","family":"Tagliabue","sequence":"additional","affiliation":[{"name":"Lombardy Cancer Registry-Varese Province, Cancer Registry Unit, Department of Research, Fondazione IRCCS Istituto Nazionale Tumori, 20133 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2907-0745","authenticated-orcid":false,"given":"Federica","family":"Toffolutti","sequence":"additional","affiliation":[{"name":"Cancer Epidemiology Unit, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, 33081 Aviano, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susanna","family":"Vitarelli","sequence":"additional","affiliation":[{"name":"Macerata Province Cancer Registry, University of Camerino, 62032 Camerino, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fabio","family":"Falcini","sequence":"additional","affiliation":[{"name":"Romagna Cancer Registry, Romagna Cancer Institute (IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) Dino Amadori), 47014 Meldola, Italy"},{"name":"Cancer Prevention Unit, Local Health Authority, 47121 Forl\u00ec, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,3,10]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1097\/01.pgp.0000177646.38266.6a","article-title":"Vulvar squamous cell carcinoma is a multifactorial disease following two separate and independent pathways","volume":"25","author":"Shirango","year":"2006","journal-title":"Int. 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