title: Management of Isolated Vaginal Metastasis in Squamous Cell Cervical Cancer: 23 Years' Experience at a Single Center.
abstract: OBJECTIVE
  The aim of this study was to investigate the treatment options and survival of cervical cancer (CC) patients who develop isolated vaginal metastasis (IVM), and to establish risk factors for IVM.
  
  
  METHODS
  A total of 21 cases with IVM were evaluated retrospectively. In addition, 42 control patients diagnosed with CC without recurrence were matched. Tumor size, depth of stromal invasion (DOI), lymphovascular space invasion (LVSI), and size of vaginal and lymph node metastases were analyzed in accordance with the pathology reports. Patients who had IVM were investigated in terms of treatment options (chemotherapy (CT), radiotherapy (RT), or chemoradiotherapy (CRT)) and survival.
  
  
  RESULTS
  After detection of IVM, the 1-, 3-, and 5-year survival rates were 57.1, 23.8, and 9.5%, respectively. The mean survival time after metastasis detection was 23.1 ± 31.3 months. LVSI, DOI ≥ 1/2, hemoglobin < 12 g/dl, postmenopausal status, and tumor size ≥ 4 cm were independent risk factors for IVM. The 5-year survival rates were 30.0% for patients receiving RT, 17.1% for patients receiving CRT, and 0% for patients receiving CT.
  
  
  CONCLUSIONS
  IVM typically develops within the first 2 years after the diagnosis of CC, and survival is generally poor. RT was the most effective treatment in patients with IVM.
authors.affiliation: Department of Gynecologic Oncology, Tepecik Education and Research Hospital, Izmir, Turkey.
authors.forename: Kemal
authors.initials: K
authors.lastname: Güngördük
authors.forename: Mustafa
authors.initials: M
authors.lastname: Kocaer
authors.forename: Varol
authors.initials: V
authors.lastname: Gülseren
authors.forename: Aykut I
authors.initials: AI
authors.lastname: Özdemir
authors.forename: Mehmet
authors.initials: M
authors.lastname: Gokcu
authors.forename: Ozgu
authors.initials: O
authors.lastname: Güngördük
authors.forename: Mustaffer
authors.initials: M
authors.lastname: Sancı
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000556:secondary* / Q000628:therapy*; D059248:Chemoradiotherapy / Q000401:mortality / Q000706:statistics & numerical data; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis / Q000401:mortality / Q000517:prevention & control; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate; D016896:Treatment Outcome; D014421:Turkey / Q000453:epidemiology; D002583:Uterine Cervical Neoplasms / Q000401:mortality* / Q000628:therapy*; D014625:Vaginal Neoplasms / Q000401:mortality / Q000556:secondary* / Q000628:therapy*
chemical_list: D000970:Antineoplastic Agents