title: Treatment failure in vaginal cancer.
abstract: OBJECTIVE
  The aim of this study was to analyze the pattern of treatment failure in patients with vaginal cancer.
  
  
  METHODS
  Fifty-one patients with primary vaginal cancer (registered between 1957 and 1995) were reviewed. Primary treatment consisted of surgery in 12 patients and radiation in 39 patients. In these patients, the prognosis and treatment failure were analyzed in relation to clinicopathological factors.
  
  
  RESULTS
  The 5-year survival rate was 100% in stage 0 (N = 5), 82% in stage I (N = 11), 70% in stage II (N = 23), 0% in stage III (N = 5), 14% in stage IV (N = 7), and 61% overall (N = 51). Although early disease had a relatively favorable prognosis, two of five patients with stage 0 disease developed local recurrence. There was no site-related difference in survival, but survival was better when the tumor occupied less than one-third of the vaginal wall compared with more than one-third. All relapses in stage 0-II patients were local recurrences, whereas treatment failure in stage III-IV patients was due to either persistent local disease or new distant metastasis.
  
  
  CONCLUSIONS
  The present findings suggest that more intensive local therapy may achieve a better prognosis for patients with early disease. Conversely, suppression of distant metastasis along with aggressive local control is needed for advanced disease. Conventional radiotherapy alone is of little value for advanced disease.
authors.affiliation: Department of Gynecology, Cancer Institute Hospital, 1-37-1 Kami-Ikebukuro, Toshima-ku, Tokyo 170-8455, Japan. tabatat@gyn.jfcr.or.jp
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Tabata
authors.forename: Nobuhiro
authors.initials: N
authors.lastname: Takeshima
authors.forename: Hidetaka
authors.initials: H
authors.lastname: Nishida
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Hirai
authors.forename: Katsuhiko
authors.initials: K
authors.lastname: Hasumi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008875:Middle Aged; D015996:Survival Rate; D017211:Treatment Failure; D014625:Vaginal Neoplasms / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery*