Three‐year survival rate and prognostic factors among women with vulvar cancer treated at Ocean Road Cancer Institute in Tanzania: A retrospective cohort study

OBJECTIVE: Vulvar cancer accounts for approximately 5% of gynecologic malignancies worldwide. Global incidence remains low (0.85 per 100 000 women). Vulvar cancer is under-reported in low- and middle-income countries, and survival data from sub-Saharan Africa remain limited. This study evaluates the 3-year survival rate and associated prognostic factors among women diagnosed with vulvar cancer at Ocean Road Cancer Institute in Tanzania. METHODS: A retrospective cohort study of 127 women with histologically confirmed vulvar cancer diagnosed between January 2019 and December 2021 was conducted. Overall survival was estimated using the Kaplan-Meier method. Cox proportional hazards regression identified mortality predictors. Analyses were performed using STATA 17. RESULTS: Among 127 patients, 61.4% were aged >45 years and 62.2% were HIV-positive. Squamous cell carcinoma (SCC) was the predominant histological subtype (89%). The 1-, 2-, and 3-year survival rates were 76.0%, 51.3%, and 39.1%, respectively. In the univariate analysis, factors associated with mortality were age greater than 45 years (P = 0.047), lymph node involvement (P = 0.046), advanced FIGO (the International Federation of Gynecology & Obstetrics) stage (P < 0.001), lack of surgical treatment (P = 0.010), and suboptimal treatment (P = 0.004) In multivariate analysis, advanced stage (adjusted hazard ratio, aHR = 2.93, P < 0.001) and suboptimal treatment (aHR = 1.91, P = 0.031) were independent predictors of mortality, with age greater than 45 years showing marginal significance (aHR = 1.62, P = 0.054). CONCLUSION: Three-year survival among women with vulvar cancer at Ocean Road Cancer Institute was poor (39.1%). SCC was the predominant histology. Advanced FIGO stage, older age, and suboptimal treatment independently predicted mortality.