title: The role of surgery in invasive squamous carcinoma of the vagina.
abstract: 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.
authors.affiliation: Northern Gynaecological Oncology Centre, Queen Elizabeth Hospital, Gateshead, NE9 6SX, United Kingdom. wiebren.tjalma@uza.uia.ac.be
authors.forename: W A
authors.initials: WA
authors.lastname: Tjalma
authors.forename: J M
authors.initials: JM
authors.lastname: Monaghan
authors.forename: A
authors.initials: A
authors.lastname: de Barros Lopes
authors.forename: R
authors.initials: R
authors.lastname: Naik
authors.forename: A J
authors.initials: AJ
authors.lastname: Nordin
authors.forename: J J
authors.initials: JJ
authors.lastname: Weyler
mesh_terms: 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*