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Vaginal Cancer Treatment (PDQ®): Treatment - Health Professional Information [NCI]-General Informati

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Vaginal Cancer Treatment (PDQ®): Treatment - Health Professional Information [NCI]-General Information About Vaginal Cancer

Vaginal Cancer Treatment (PDQ®): Treatment - Health Professional Information [NCI] - General Information About Vaginal Cancer


Vaginal Cancer Treatment (PDQ®): Treatment - Health Professional Information [NCI] Guide



Vaginal adenosis is most commonly found in young women who had in utero exposure to DES and may coexist with a clear cell adenocarcinoma, though it rarely progresses to adenocarcinoma. Adenosis is replaced by squamous metaplasia, which occurs naturally, and requires follow-up but not removal.

Rarely, melanomas (often nonpigmented), sarcomas, or small-cell carcinomas have been described as primary vaginal cancers.

Prognostic Factors

Patient prognosis depends primarily on the stage of disease, but survival is reduced among those who are older than 60 years, are symptomatic at the time of diagnosis, have lesions of the middle and lower third of the vagina, or have poorly differentiated tumors.

In addition, the length of vaginal wall involvement has been found to be associated with survival and stage of disease in vaginal SCC patients.

Non-DES-associated adenocarcinomas generally have a worse prognosis than SCC tumors, but DES-associated clear cell tumors have a relatively good prognosis.[5] The natural history, prognosis, and treatment of other primary vaginal cancers (i.e., sarcoma, melanoma, lymphoma, and carcinoid tumors) are different and are not covered in this summary.

Treatment Options

Therapeutic options depend on tumor stage; surgery and radiation therapy are highly effective in early stages, whereas radiation therapy is the primary treatment of more advanced stages. Chemotherapy has not been shown to be curative for advanced vaginal cancer, and there are no standard drug regimens.

References:

  1. American Cancer Society.: Cancer Facts and Figures 2014. Atlanta, Ga: American Cancer Society, 2014. Available online. Last accessed March 26, 2014.
  2. Eifel PJ, Berek JS, Markman MA: Cancer of the cervix, vagina, and vulva. In: DeVita VT Jr, Lawrence TS, Rosenberg SA: Cancer: Principles and Practice of Oncology. 9th ed. Philadelphia, Pa: Lippincott Williams & Wilkins, 2011, pp 1311-44.
  3. Stock RG, Chen AS, Seski J: A 30-year experience in the management of primary carcinoma of the vagina: analysis of prognostic factors and treatment modalities. Gynecol Oncol 56 (1): 45-52, 1995.
  4. Vagina. In: Edge SB, Byrd DR, Compton CC, et al., eds.: AJCC Cancer Staging Manual. 7th ed. New York, NY: Springer, 2010, pp 387-9.
  5. Eifel P, Berek J, Markman M: Cancer of the cervix, vagina, and vulva. In: DeVita VT Jr, Hellman S, Rosenberg SA, eds.: Cancer: Principles and Practice of Oncology. Vols. 1 & 2. 8th ed. Philadelphia, Pa: Lippincott Williams & Wilkins, 2008, pp 1496-1543.
  6. Daling JR, Madeleine MM, Schwartz SM, et al.: A population-based study of squamous cell vaginal cancer: HPV and cofactors. Gynecol Oncol 84 (2): 263-70, 2002.
  7. Parkin DM: The global health burden of infection-associated cancers in the year 2002. Int J Cancer 118 (12): 3030-44, 2006.
  8. Ikenberg H, Runge M, Göppinger A, et al.: Human papillomavirus DNA in invasive carcinoma of the vagina. Obstet Gynecol 76 (3 Pt 1): 432-8, 1990.
  9. Herbst AL, Ulfelder H, Poskanzer DC: Adenocarcinoma of the vagina. Association of maternal stilbestrol therapy with tumor appearance in young women. N Engl J Med 284 (15): 878-81, 1971.

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