Primary carcinoma of the vagina: factors influencing the age at diagnosis. The Radiumhemmet series 1956-96

Abstract

The objective to this retrospective study of 341 cases of primary carcinoma of vagina (PCV) diagnosed between 1956 and 1996 was to find whether epidemiological, clinical, and histopathological variables were related to the age at diagnosis of patients with PCV. The univariate statistical analysis showed that younger age at diagnosis significantly correlated with a history of cervical dysplasia, hysterectomy, gynecological infections, and tumors located in the upper part of the vagina, whereas older age at diagnosis significantly correlated with late menarche and exophytically growing tumors. In the multivariate regression analysis, the remaining independent predictors were a history of cervical dysplasia and age at menarche. Further, parity >/=4 as well as nulliparity, smoking, and unstable marital status were more common among patients with PCV than among those in the general Swedish female population. This study indicates that the etiology of vaginal carcinoma may be age related. In young patients, the disease seems to be etiologically related to cervical neoplasia and thus human papillomavirus (HPV) dependent. However, in the most common age group, the older patients, there might be another (probably non-HPV-related) etiology associated with hormonal factors and trauma to the vagina.

Retrospective evaluation of clinical and pathological features, as well as diagnostic and treatment protocols of primary vaginal malignancy

“…SCC of the vagina is the most common histological type, and its frequency is estimated at 85% [12][13][14]. Histological features of the patients enrolled in our study were consistent with the literature.…”

Effects of neoadjuvant chemotherapy on patients with primary vaginal squamous cell carcinoma

“…The main histopathological types of primary vaginal carcinoma include SCC, adenocarcinoma, malignant melanoma and sarcoma. SCC is the most common histotype and accounts for 85-95% of all cases (2,3,16). The incidence of SCC increases with age, with ~50% patients aged >70 years at diagnosis.…”

“…The incidence of SCC increases with age, with ~50% patients aged >70 years at diagnosis. The main pathogenic risk factors include human papillomavirus infection, injury through use of pessaries, previous gynecological disorders, multiple sexual partners, earlier pelvic irradiation, and smoking (16)(17)(18). The high-risk prognostic factors include age at onset, tumor size, clinical stage and pathological type.…”

“…Other studies suggested that the vagina and the cervix are lined with the same type of squamous cell epithelium, and several risk factors are shared by cervical and vaginal carcinoma. Accordingly, the etiology is similar for these two cancers (16). Thus, irinotecan combined with platinum for the treatment of advanced cervical cancer has exhibited confirmed therapeutic efficacy; however, there is little evidence regarding its efficacy against vaginal cancer.…”

“…It has been suggested that, as the vagina and the cervix are lined with the same type of squamous cell epithelium, the same risk factors are present in both cervical and vaginal carcinomas (16). The aim of the present study was to evaluate the effect of neoadjuvant chemotherapy on patients with primary vaginal SCC.…”