Vaginal cancer

Because of the low incidence of vaginal cancer, phase III trials have not been carried out and current guidelines have been drawn on retrospective studies. This state of affairs explains the variety of treatments to which women affected by this disease are subjected to. In this article, we report the current results achieved by different therapeutic strategies. The primary treatment options in Stage I vaginal carcinoma are surgery and/or radiotherapy. For a small tumor, a wide excision can be used. For high risk patients, a more aggressive surgery is mandatory. The most frequently adopted treatment strategy for Stage II is a combination of brachytherapy and EBRT. Selected patients may be treated by radical surgery. Neoadjuvant chemotherapy followed by radical surgery is a valid alternative to the standard treatment in terms of survival. Combination of EBRT and brachytherapy is the most commonly adopted treatment in stages III-IV A and, in selected patients, pelvic exenteration or a combination of irradiation and exenteration can be used.