Surgical outcomes of early-stage primary vaginal nonsquamous cell carcinoma

Int J Clin Oncol. 2020 Jul;25(7):1412-1417. doi: 10.1007/s10147-020-01663-4. Epub 2020 Mar 27.

Abstract

Objective: Definitive radiation therapy (RT), using external beam RT and/or brachytherapy, is a standard treatment option for primary vaginal carcinoma. However, this treatment has poor prognosis when applied to vaginal nonsquamous cell carcinoma (non-SCC). We aimed to clarify treatment outcome and surgical safety in early-stage primary vaginal non-SCC.

Methods: After receiving approval from the institutional review board, we retrospectively reviewed the clinical records and pathological samples of patients treated at our hospital between 1991 and 2018. Among 49 patients with primary vaginal carcinoma, 12 with histologically confirmed early-stage primary vaginal non-SCC were included in this study.

Results: In total, 40% of patients with primary vaginal carcinoma treated at our hospital had primary vaginal non-SCC. The average observation time was 34 months (median 53.3 months). Three patients had local recurrence: 2 in pelvic lymph nodes and 1 in the vagina. Furthermore, 2 patients died of their disease. Five-year local control rate of stage I and stage II non-SCC was 75% and 100%, respectively. Disease-specific survival rate of stage I and stage II non-SCC was 81.8% and 100%, respectively. No major morbidity was observed. Three patients required allogeneic blood transfusion, whereas 1 underwent autotransfusion. None of the 12 patients were discharged with self-catheterization.

Conclusion: Five-year local control and disease-specific survival rates of patients surgically treated for vaginal non-SCC were favorable. Therefore, surgery could be a safe and reasonable option for early-stage primary vaginal non-SCC.

Keywords: 5-year local control rate; Disease-specific survival rates; Nonsquamous cell carcinoma; Radiation therapy.

MeSH terms

  • Adult
  • Aged
  • Female
  • Humans
  • Lymph Nodes / pathology
  • Middle Aged
  • Neoplasm Recurrence, Local / pathology
  • Pelvis / pathology
  • Retrospective Studies
  • Survival Rate
  • Treatment Outcome
  • Vaginal Neoplasms / mortality
  • Vaginal Neoplasms / pathology*
  • Vaginal Neoplasms / surgery*