[Clinical course and radiotherapy of primary vaginal cancer (362 cases)]

362 cases of primary vaginal carcinoma were treated at the Irradiation Department of the University Clinic for Obstetrics and Gynaecology, Vienna, from 1950 to 1977. As method of choice an individually dosed, fractioned and protracted radium-telecobalt therapy was employed. An overall 5-years' survival rate of 39.8% could be achieved, a value which is above the average reported in world literature. Comparing the last period analysed in the present study (1971 to 1977) with another period 20 years earlier (1951-1956), the following differences can be observed: the fraction of stages III and IV rose markedly from 57.2% to 68.7%; associated with this change was an increase of the percentage of older patients (greater than 60a) from 53.6% to 70.7%. These two developments had an impact on the survival rate: in the total population, it was 39.8% as compared to 32% for the period from 1971 to 1977. The 5-year-survival rate in stage I (n = 60) was 75%, in stage II (n = 95) 45.3%, in stage III (n = 145) 30.3% and in stage IV (n = 62) 19.3%. The incidence of rectovaginal or vesico-vaginal fistulas amounted to 8%. The importance of gynaecological screening for old age patients is emphasized being the only possibility for reducing the high percentage of progressed stages.