An evaluation of stage II vaginal clear cell adenocarcinoma according to substages

Of the 76 cases of stage II vaginal clear cell adenocarcinoma reviewed, the lesion involved the vesicovaginal and/or rectovaginal septa (IIc) in 19, the paravaginal/parametrial tissues without extension onto the pelvic sidewall (IIb) in 8, and the subvaginal tissue without paravaginal/parametrial or septal infiltration (IIa) in 36; the substage could not be determined in 13 cases. The three substage groups were similar with regard to maternal hormone history, greatest tumor diameter, depth of invasion, cross-sectional tumor area, location of the lesion in the vagina, predominant histologic pattern and cell type, mitoses, grade, lymph node status, and treatment modality. Actuarial survival rates at 5 and 10 years for all patients with stage II vaginal clear cell adenocarcinoma were 83 and 62%, respectively. The recurrence and survival experiences for the three substage groups were similar. The data available do not suggest any clinical benefit to categorizing cases of stage II vaginal clear cell adenocarcinoma into substages.