The role of surgery in invasive squamous carcinoma of the vagina.
OBJECTIVE
The aim of this study was to define the role of surgery in managing patients with a primary squamous vaginal cancer.


METHODS
A retrospective review was conducted of patients with primary invasive vaginal cancer managed at one institution over a 25-year period. The results were compared with those of all major publications of the past 20 years.


RESULTS
A total of 84 patients were reviewed. Forty-five (66%) were of squamous origin. The median follow-up was 45 months (range: 0.6-268). The patients were primarily treated by surgery in 67% and by radiotherapy alone in 33% of cases. The 5- and 10-year overall survival was, respectively, 74 and 58%. For stage I the figures were 91 and 70%. These survival rates compared favorably with those of published series of cases managed by radiotherapy alone. Univariate analysis showed that age (P = 0.004), size (P = 0.009), site (P = 0.016), lymph node status (P = 0.022), FIGO stage (P = 0.027), and treatment (P = 0.003) were relevant prognostic factors. Multiple regression analysis, however, revealed that only age (P = 0.009) and size (P = 0.037) were independent prognostic variables.


CONCLUSIONS
Stage I and II squamous vaginal cancer patients have good outcomes in terms of survival and local tumor control if they are managed by initial surgery followed by selective radiotherapy.
Tjalma
W A
WA
Northern Gynaecological Oncology Centre, Queen Elizabeth Hospital, Gateshead, NE9 6SX, United Kingdom. wiebren.tjalma@uza.uia.ac.be
Monaghan
J M
JM
de Barros Lopes
A
A
Naik
R
R
Nordin
A J
AJ
Weyler
J J
JJ
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery*; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D012189:Retrospective Studies; D015996:Survival Rate; D014625:Vaginal Neoplasms / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery*