Primary carcinoma of the vagina: Tata Memorial Hospital experience

Pingley, Sonali; Shrivastava, Shyam K.; Sarin, Rajiv; Agarwal, Jai Prakash; Laskar, Siddharth; Deshpande, Deepak D.; Dinshaw, Ketayun A.

doi:10.1016/s0360-3016(99)00360-0

Cited by 59 publications

(22 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Disease-free and overall survival rates published in one of the large series by Pingley et al[24] is comparable to outcome results of the non-IBBT subgroup of our study. In this study by Pingley et al, 5- year DFS and OS rates for a subset of 59 patients who received non-image-based BT (intracavitary and Interstitial) for primary vaginal cancer were 53% and 56% respectively.…”

Section: Discussionsupporting

confidence: 90%

Outcomes with image-based interstitial brachytherapy for vaginal cancer

Manuel

Cho

Catalano

et al. 2016

Radiotherapy and Oncology

View full text Add to dashboard Cite

PURPOSE To compare clinical outcomes of image-based versus non-image-based interstitial brachytherapy (IBBT) for vaginal cancer METHODS AND MATERIALS Of 72 patients with vaginal cancer treated with brachytherapy (BT), 47 had image guidance (CT=31, MRI=16) and 25 did not. Kaplan-Meier (KM) estimates were generated for any recurrence, local control (LC), disease-free interval (DFI), and overall survival (OS) and Cox models were used to assess prognostic factors. RESULTS Median age was 66 and median follow-up time was 24 months. Median cumulative EQD2 dose was 80.8 Gy in the non-IBBT group and 77 Gy in the IBBT group. For non-IBBT versus IBBT, the 2-year KM LC was 71% vs. 93% (p=0.03); DFI was 54% vs. 86% (p=0.04); and OS 52% vs. 82% (p=0.35). On multivariate analysis, IBBT was associated with better DFI (HR 0.24, 95% CI 0.07–0.73). Having any 2 or more of chemotherapy, high-dose-rate (HDR) BT or IBBT (temporally correlated variables) significantly reduced risk of relapse (HR=0.33, 95% CI= 0.13–0.83), compared to having none of these factors. CONCLUSION Over time, the use of chemotherapy, HDR and IBBT has increased in vaginal cancer. The combination of these factors resulted in the highest rates of disease control. Image-guided brachytherapy for vaginal cancer patients maximizes disease control.

show abstract

Section: Discussionsupporting

confidence: 90%

Outcomes with image-based interstitial brachytherapy for vaginal cancer

Manuel

Cho

Catalano

et al. 2016

Radiotherapy and Oncology

View full text Add to dashboard Cite

show abstract

“…In accordance with other studies (8,30,42) , inguinal lymph node involvement at presentation was a strong significant indicator of poor survival, as well as growth into the septum rectovaginale, indicating a more aggressive behavior of the disease. The fact that tumors in the lower third of the vagina have been considered to have a worse prognosis is possibly related to an early high incidence of lymph node metastases found in some studies (8) .…”

Section: Discussionsupporting

confidence: 91%

Clinical and histopathologic factors related to prognosis in primary squamous cell carcinoma of the vagina

Hellman

Lundell

Silfverswärd³

et al. 2006

Int J Gynecol Cancer

View full text Add to dashboard Cite

The goal of this retrospective study concerning primary carcinoma of the vagina (PCV) was to analyze clinical and histopathologic prognostic factors in one of the largest known material, which comprised 314 patients. PCV is a rare disease, and the majority of published studies are based on small materials; therefore, the established knowledge concerning prognostic factors is insufficient. Routine treatment is based on irradiation with risk for undertreatment or overtreatment, which leads to unnecessary complications in the absence of prognostic factors. The overall 5-year disease-specific survival rate in this study was 45% and in stage I 75%. In the univariate statistical analysis, several factors correlated significantly with disease-specific survival. However, in the multivariate analysis, there were only three factors that independently could predict poor survival-high age at diagnosis, large tumors (> or =4 cm), and advanced stage. Common background factors with no prognostic significance were prior hysterectomy, other gynecological malignancies, and pelvic irradiation. In conclusion, this study has elucidated three strong prognostic factors that might be considered in the choice of therapy and also for modification of the FIGO guidelines. Increased knowledge concerning complementary biologic markers to discriminate between low- and high malignant tumors is however of great importance.

show abstract

“…External-beam therapy has become important for the treatment of advanced tumors since it reaches the infiltrating deeper tumor components that may not be sufficiently irradiated by intracavitary or interstitial sources alone. Regional lymph nodes that may be infiltrated by micrometastases can also be treated by this mode of therapy [22,30,43]. Retrospective studies revealed overall 5-year survival rates of about 40% for invasive tumors treated with external radiotherapy combined with brachytherapy [1,[27][28][29]38].…”

Section: Discussionmentioning

confidence: 99%

Long-Term Results of Radiotherapy in Primary Carcinoma of the Vagina

et al. 2009

View full text Add to dashboard Cite

Background:The long-term results of radiotherapy in primary carcinoma of the vagina are not well defined. Patients and Methods: The treatment results of 41 patients with primary malignancies of the vagina were analyzed. The mean follow-up period was 77.3 months (2.3-404 months). The predominant histology was squamous cell carcinoma, FIGO stages I: n = 7 (17.1%), II: n = 13 (31.7%), III: n = 13 (31.7%), and IVa: n = 8 (19.5%). Radiotherapy was the primary treatment for all patients. None of the patients had undergone prior surgery for vaginal carcinoma. The majority of patients received pelvic irradiation, including treatment of the inguinal lymphatics (median dose: 50 Gy). 26 patients received additional intravaginal brachytherapy. Results: Overall, 21 patients (51.2%) achieved complete remission, 17 patients (41.5%) had partial responses, and three patients (7.3%) had no change or progressive disease. The total median survival of the analyzed patients was 41.3 months. The 1-year survival probability was 85.4%, the 5-year survival probability 40.6%, and the 10-year survival probability 27.2%. Univariate analysis revealed a survival advantage for earlier tumor stages (FIGO I and II) compared to advanced stages (FIGO III and IV), with a median survival of 58.1 months compared to 26.8 months. Treatment side effects were tolerable and easily managed. Conclusion: Definite radiotherapy is the treatment of choice for primary carcinomas of the vagina. Considering that primary malignancies of the vagina are typically diseases of the elderly, it should be noted that radiotherapy is especially well tolerated in this population. Langzeitergebnisse der Strahlentherapie beim primären VaginalkarzinomHintergrund: Die Langzeitergebnisse der Strahlentherapie beim primären Vaginalkarzinom sind nicht gut definiert. Patienten und Methodik: Die Behandlungsergebnisse von 41 Patientinnen mit primären Vaginalkarzinomen wurden analysiert. Der mittlere Nachbeobachtungszeitraum betrug 77,3 Monate (2,3-404 Monate). Histologisch lagen überwiegend Plattenepithelkarzinome vor, FIGO-Stadien I: n = 7 (17,1%), II: n = 13 (31,7%), III: n = 13 (31,7%), IVa: n = 8 (19,5%). Bei allen Patientinnen war die Strahlentherapie die primäre Behandlungsform, keine Patientin hatte sich vor Bestrahlungsbeginn einer chirurgischen Intervention unterzogen. Der Großteil der Patientinnen erhielt eine Beckenbestrahlung, welche die inguinalen Lymphbahnen einschloss (mittlere Dosis: 50 Gy). 26 Patientinnen erhielten zusätzlich eine intravaginale Brachytherapie. Ergebnisse: Insgesamt erreichten 21 Patientinnen (51,2%) eine komplette Remission, 17 Patientinnen (41,5%) wiesen eine partielle Remission auf, und drei Patientinnen (7,3%) zeigten keine Veränderung bzw. ein Fortschreiten der Erkrankung. Das Gesamtüberleben für alle Patientinnen lag im Median bei 41,3 Monaten. Die 1-Jahres-Überlebenswahrscheinlichkeit betrug 85,4%, die 5-Jahres-Überlebenswahrscheinlichkeit 40,6% und die 10-Jahres-Überlebenswahrscheinlichkeit 27,2%. Die univariate Analyse zeigte einen Überlebensvo...

show abstract

Primary carcinoma of the vagina: Tata Memorial Hospital experience

Cited by 59 publications

References 35 publications

Outcomes with image-based interstitial brachytherapy for vaginal cancer

Outcomes with image-based interstitial brachytherapy for vaginal cancer

Clinical and histopathologic factors related to prognosis in primary squamous cell carcinoma of the vagina

Long-Term Results of Radiotherapy in Primary Carcinoma of the Vagina

Contact Info

Product

Resources

About