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Published on: May 10, 2022
Vaginectomy: a minimally invasive treatment for cervical cancer vaginal recurrence
Pierluigi Benedetti Panici1, Natalina Manci, Filippo Bellati
1Department of Gynecology, Perinatology and Child Health, University of Rome La Sapienza, Viale del Policlinico, Rome, Italy. pierluigi.benedettipanici@uniroma1.it
Objective:
Radiotherapy and/or pelvic exenteration represent the treatment of vaginal recurrence, but the prognosis remains unsatisfactory and with long-term complications. We investigated the possible role of vaginectomy for isolated vaginal relapse (IVR) in cervical cancer (CC).
Methods:
Patients with vaginal CC recurrence were evaluated for surgical treatment consisting in vaginectomy. Data were prospectively collected and analyzed to identify independent prognostic factors.
Results:
Twenty-nine patients with IVR from CC were enrolled. Early and late complications were observed in 7 (24%) and 6 (21%) patients, respectively. After a median follow-up of 57.5 months (range, 8-100 months), 16 patients (55%) were disease-free. The 5-year overall survival and progression-free survival rates were 70.5% and 59.4%, respectively.
Conclusions:
In carefully selected patients, vaginectomy may be considered a therapeutic option for IVR. Older patients with long disease-free interval and small recurrences benefit the most from this bladder-sparing surgical technique.