Vaginectomy: a minimally invasive treatment for cervical cancer vaginal recurrence.
OBJECTIVE
Radiotherapy and/or pelvic exenteration represent the treatment of vaginal recurrence, but the prognosis remains unsatisfactory and with long-term complications. We investigated the possible role of vaginectomy for isolated vaginal relapse (IVR) in cervical cancer (CC).


METHODS
Patients with vaginal CC recurrence were evaluated for surgical treatment consisting in vaginectomy. Data were prospectively collected and analyzed to identify independent prognostic factors.


RESULTS
Twenty-nine patients with IVR from CC were enrolled. Early and late complications were observed in 7 (24%) and 6 (21%) patients, respectively. After a median follow-up of 57.5 months (range, 8-100 months), 16 patients (55%) were disease-free. The 5-year overall survival and progression-free survival rates were 70.5% and 59.4%, respectively.


CONCLUSIONS
In carefully selected patients, vaginectomy may be considered a therapeutic option for IVR. Older patients with long disease-free interval and small recurrences benefit the most from this bladder-sparing surgical technique.
Benedetti Panici
Pierluigi
P
Department of Gynecology, Perinatology and Child Health, University of Rome La Sapienza, Viale del Policlinico, Rome, Italy. pierluigi.benedettipanici@uniroma1.it
Manci
Natalina
N
Bellati
Filippo
F
Di Donato
Violante
V
Marchetti
Claudia
C
De Falco
Carmen
C
Di Tucci
Chiara
C
Angioli
Roberto
R
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D013509:Gynecologic Surgical Procedures / Q000379:methods*; D006801:Humans; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D011183:Postoperative Complications / Q000453:epidemiology; D011379:Prognosis; D012008:Recurrence; D016019:Survival Analysis; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D014621:Vagina / Q000601:surgery*; D014625:Vaginal Neoplasms / Q000517:prevention & control*