Vaginal cytology following primary hysterectomy for cervical cancer: is it useful?
BACKGROUND
Vaginal intraepithelial neoplasia (VAIN) is usually detected in patients with synchronous or antecedent cervical or vulval intraepithelial or invasive cancer. VAIN has the potential to progress to malignancy.


OBJECTIVE
To determine the incidence and severity and analyse the management of vaginal dysplasia in patients undergoing primary hysterectomy for cervical cancer.


METHODS
A retrospective study (1984-1998) identified 210 primary invasive cervical cancers. One-hundred and twenty-three patients had a primary hysterectomy.


RESULTS
In follow-up six patients were found to have dyskaryosis in a second vaginal smear. Biopsies in the six patients with colposcopic lesions showed VAIN II (n=2), VAIN III (n=1),VAIN III / possible early invasion (n = 1) and invasive carcinoma (n=2). One patient with recurrent squamous cancer received salvage radiotherapy and one with recurrent adenocarcinoma received high dose progestogens and topical 5-fluorouracil.


CONCLUSIONS
All patients are disease-free at follow-up.
Coughlan
C
C
Dept of Obstetrics & Gynaecology (Gynaecological Oncology), Coombe Women's Hospital, Dublin. caroljcoughlan@eircom.net
McAuliffe
F
F
Bermingham
N
N
Gleeson
N
N
D005260:Female; D006801:Humans; D007044:Hysterectomy; D008875:Middle Aged; D012189:Retrospective Studies; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000556:secondary; D014621:Vagina / Q000166:cytology*; D014625:Vaginal Neoplasms / Q000175:diagnosis* / Q000556:secondary; D014626:Vaginal Smears / Q000706:statistics & numerical data