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.

中文翻译：

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早期原发性阴道非鳞状细胞癌的手术结局。

摘要

目的

使用外照射和/或近距离放射治疗的确定性放射治疗（RT）是原发性阴道癌的标准治疗选择。但是，这种疗法应用于阴道非鳞状细胞癌（非SCC）时预后较差。我们旨在阐明早期原发性阴道非SCC的治疗结果和手术安全性。

方法

在获得机构审查委员会的批准后，我们​​对1991年至2018年间在我院接受治疗的患者的临床记录和病理样本进行了回顾性研究。在49例原发性阴道癌患者中，有12例经组织学确认为早期原发性阴道非SCC的患者为包括在这项研究中。

结果

在我们医院接受治疗的原发性阴道癌患者中，共有40％患有原发性阴道非SCC。平均观察时间为34个月（中位数为53.3个月）。3例患者局部复发：盆腔淋巴结肿大2例，阴道1例。此外，有2名患者死于疾病。I期和II期非SCC的五年本地控制率分别为75％和100％。I期和II期非SCC疾病特异性生存率分别为81.8％和100％。没有观察到重大发病。3名患者需要进行同种异体输血，而1名接受了自体输血。12例患者均未进行自我导管治疗。

结论

经阴道非SCC手术治疗的患者的五年局部控制和疾病特异性生存率良好。因此，对于早期原发性阴道非SCC，手术可能是安全合理的选择。