Conservative treatment of reproductive and sexual function in young woman with squamous carcinoma of the vagina.
OBJECTIVE
Primary squamous carcinoma of the vagina in young woman is extremely rare. Conservative management of both sexual and reproductive function poses challenging problems to gynecologic oncologists.


METHODS
Between January 2001 and December 2004, four women under 40, nulliparous, with squamous cell carcinoma of the upper third of the vagina, at FIGO Stage I were submitted to conservative surgery of the reproductive/sexual function at our Institution. After written informed consent was obtained, conservative surgical treatment consisting of radical tumorectomy with pelvic lymphadenectomy, in three patients, and partial hemi-vaginectomy plus homolateral paracolpectomy/parametrectomy with pelvic lymphadenectomy, in the forth patient, was carried out.


RESULTS
Mean operative time of conservative surgical treatment was 161 min. No intraoperative or postoperative complications were observed. In one patient, definitive pathologic examination revealed microscopic involvement of the paracolpium. Thus, after carrying out laparoscopic ovarian transposition, adjuvant radiotherapy (RT), consisting of pulsed-dose rate brachytherapy and external RT, was delivered in this woman. After a follow-up time of 51, 45, 21 and 9 months, respectively, all patients are regularly menstruating, sexually active and clinically free of disease.


CONCLUSIONS
To our knowledge, this is the first report showing the feasibility and the efficacy of conservative surgery of reproductive and sexual function in young woman with vaginal carcinoma. A larger number of patients and a longer follow-up are needed to validate the safety of this approach.
Cutillo
Giuseppe
G
Division of Gynecologic Oncology, Department of Surgery, National Cancer Institute, Via Elio Chianesi, 53 Rome 00144, Italy. giuseppe.cutillo@fastwebnet.it
Cignini
Pietro
P
Pizzi
Gianbeppi
G
Vizza
Enrico
E
Micheli
Adriana
A
Arcangeli
Giorgio
G
Sbiroli
Carlo
C
D000328:Adult; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008598:Menstruation; D009367:Neoplasm Staging; D011788:Quality of Life; D012098:Reproduction; D012725:Sexual Behavior; D014625:Vaginal Neoplasms / Q000473:pathology / Q000601:surgery*