Vaginectomy: a minimally invasive treatment for cervical cancer vaginal recurrence

Int J Gynecol Cancer. 2009 Dec;19(9):1625-31. doi: 10.1111/IGC.0b013e3181a80a0a.

Abstract

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.

Publication types

  • Clinical Trial

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Carcinoma, Squamous Cell / diagnosis
  • Carcinoma, Squamous Cell / mortality
  • Carcinoma, Squamous Cell / pathology
  • Carcinoma, Squamous Cell / surgery*
  • Feasibility Studies
  • Female
  • Follow-Up Studies
  • Gynecologic Surgical Procedures / methods*
  • Humans
  • Middle Aged
  • Minimally Invasive Surgical Procedures / methods
  • Postoperative Complications / epidemiology
  • Prognosis
  • Recurrence
  • Survival Analysis
  • Uterine Cervical Neoplasms / diagnosis
  • Uterine Cervical Neoplasms / mortality
  • Uterine Cervical Neoplasms / pathology
  • Uterine Cervical Neoplasms / surgery*
  • Vagina / surgery*
  • Vaginal Neoplasms / prevention & control*