Impact of disease stage, treatment timing, and demographic disparities on survival in vulvar squamous cell carcinoma: Insights from a SEER-based analysis

Eva Shelton; Janmesh Patel; Mitchell A. Taylor; Zachary Kwapnoski; Yaohui G. Xu

doi:10.1016/j.jaad.2025.10.013

Impact of disease stage, treatment timing, and demographic disparities on survival in vulvar squamous cell carcinoma: Insights from a SEER-based analysis

Eva Shelton, Janmesh Patel, Mitchell A. Taylor, Zachary Kwapnoski, Yaohui G. Xu

Advocate Health - Midwest

University of Wisconsin Department of Dermatology, Madison, WI.
Department of Orthopedics, School of Medicine and Public Health, University of Wisconsin, Madison, WI.
University of Wisconsin Department of Dermatology, Madison, WI; University of Wisconsin School of Medicine and Public Health, Madison, WI. Electronic address: [email protected].

Research output: Contribution to journal › Article

Abstract

Background: Vulvar squamous cell carcinoma (VSCC) is a rare gynecologic malignancy with understudied survival outcomes. This study leverages SEER data to refine prognostic understanding and inform clinical decision-making.

Objectives: To assess overall survival (OS) in VSCC based on disease stage, treatment sequencing, timing, and demographic factors.

Methods: This retrospective SEER study analyzed 15,055 VSCC patients (2000-2021). OS was evaluated using Kaplan-Meier analyses, stratified by disease stage, treatment modality, and timing. Socioeconomic factors, including race, income, and geographic location, were assessed for survival disparities.

Results: Patients with regional or distant metastasis had significantly worse OS compared to those with localized disease. In regional metastasis, surgery alone was associated with the best survival, with no additional benefit observed from radiation sequencing. In distant metastasis, surgery with radiation was associated with the best outcomes, and all treatment groups showed improved OS compared to no treatment. Early treatment (

Conclusions: Optimizing treatment sequencing, ensuring timely intervention, and addressing disparities are critical to improving VSCC outcomes. Limitations include the retrospective nature of SEER data and lack of information on comorbidities, HPV status, and chemotherapy use.

Original language	American English
Journal	Journal of the American Academy of Dermatology
DOIs	https://doi.org/10.1016/j.jaad.2025.10.013
Status	Published - Oct 6 2025

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Cite this

@article{483e9e0fb3604b1b9e205d1ff3484680,

title = "Impact of disease stage, treatment timing, and demographic disparities on survival in vulvar squamous cell carcinoma: Insights from a SEER-based analysis",

abstract = "Background: Vulvar squamous cell carcinoma (VSCC) is a rare gynecologic malignancy with understudied survival outcomes. This study leverages SEER data to refine prognostic understanding and inform clinical decision-making. Objectives: To assess overall survival (OS) in VSCC based on disease stage, treatment sequencing, timing, and demographic factors. Methods: This retrospective SEER study analyzed 15,055 VSCC patients (2000-2021). OS was evaluated using Kaplan-Meier analyses, stratified by disease stage, treatment modality, and timing. Socioeconomic factors, including race, income, and geographic location, were assessed for survival disparities. Results: Patients with regional or distant metastasis had significantly worse OS compared to those with localized disease. In regional metastasis, surgery alone was associated with the best survival, with no additional benefit observed from radiation sequencing. In distant metastasis, surgery with radiation was associated with the best outcomes, and all treatment groups showed improved OS compared to no treatment. Early treatment ( Conclusions: Optimizing treatment sequencing, ensuring timely intervention, and addressing disparities are critical to improving VSCC outcomes. Limitations include the retrospective nature of SEER data and lack of information on comorbidities, HPV status, and chemotherapy use.",

author = "Eva Shelton and Janmesh Patel and Taylor, \{Mitchell A.\} and Zachary Kwapnoski and Xu, \{Yaohui G.\}",

year = "2025",

month = oct,

day = "6",

doi = "10.1016/j.jaad.2025.10.013",

language = "American English",

journal = "Journal of the American Academy of Dermatology",

}

TY - JOUR

T1 - Impact of disease stage, treatment timing, and demographic disparities on survival in vulvar squamous cell carcinoma: Insights from a SEER-based analysis

AU - Shelton, Eva

AU - Patel, Janmesh

AU - Taylor, Mitchell A.

AU - Kwapnoski, Zachary

AU - Xu, Yaohui G.

PY - 2025/10/6

Y1 - 2025/10/6

N2 - Background: Vulvar squamous cell carcinoma (VSCC) is a rare gynecologic malignancy with understudied survival outcomes. This study leverages SEER data to refine prognostic understanding and inform clinical decision-making. Objectives: To assess overall survival (OS) in VSCC based on disease stage, treatment sequencing, timing, and demographic factors. Methods: This retrospective SEER study analyzed 15,055 VSCC patients (2000-2021). OS was evaluated using Kaplan-Meier analyses, stratified by disease stage, treatment modality, and timing. Socioeconomic factors, including race, income, and geographic location, were assessed for survival disparities. Results: Patients with regional or distant metastasis had significantly worse OS compared to those with localized disease. In regional metastasis, surgery alone was associated with the best survival, with no additional benefit observed from radiation sequencing. In distant metastasis, surgery with radiation was associated with the best outcomes, and all treatment groups showed improved OS compared to no treatment. Early treatment ( Conclusions: Optimizing treatment sequencing, ensuring timely intervention, and addressing disparities are critical to improving VSCC outcomes. Limitations include the retrospective nature of SEER data and lack of information on comorbidities, HPV status, and chemotherapy use.

AB - Background: Vulvar squamous cell carcinoma (VSCC) is a rare gynecologic malignancy with understudied survival outcomes. This study leverages SEER data to refine prognostic understanding and inform clinical decision-making. Objectives: To assess overall survival (OS) in VSCC based on disease stage, treatment sequencing, timing, and demographic factors. Methods: This retrospective SEER study analyzed 15,055 VSCC patients (2000-2021). OS was evaluated using Kaplan-Meier analyses, stratified by disease stage, treatment modality, and timing. Socioeconomic factors, including race, income, and geographic location, were assessed for survival disparities. Results: Patients with regional or distant metastasis had significantly worse OS compared to those with localized disease. In regional metastasis, surgery alone was associated with the best survival, with no additional benefit observed from radiation sequencing. In distant metastasis, surgery with radiation was associated with the best outcomes, and all treatment groups showed improved OS compared to no treatment. Early treatment ( Conclusions: Optimizing treatment sequencing, ensuring timely intervention, and addressing disparities are critical to improving VSCC outcomes. Limitations include the retrospective nature of SEER data and lack of information on comorbidities, HPV status, and chemotherapy use.

U2 - 10.1016/j.jaad.2025.10.013

DO - 10.1016/j.jaad.2025.10.013

M3 - Article

C2 - 41061976

JO - Journal of the American Academy of Dermatology

JF - Journal of the American Academy of Dermatology

ER -