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Treatment of vaginal recurrence in endometrial cancer. A review
1Finsen Center, Rigshospitalet, University of Copenhagen, Denmark.
Background:
We have reviewed the literature concerning vaginal recurrence in endometrial cancer with emphasis on prognostics and therapeutic results. Compared to the overall outcome of recurrences (11-17 per cent survive more than 3-19 years) the survival rate of strictly vaginal recurrence appears significantly higher (up to 60-70 per cent survive more than 5 years). However, the prognosis deteriorates significantly in cases where recurrences prove to be more widespread. Other factors towards predicting a poor outcome are high age, high stage, high grade, detection of papillary carcinoma, rapid recurrence, location to the lower part of vagina, large tumor size, and previous radiation.
Methods:
Different methods of initial treatment and cross-relations between most prognostic factors renders any ranking of prognostic factors almost impossible.
Results:
Standard treatment of vaginal recurrence including combined external and intra vaginal radiation used for decades have been unable to improve survival rate.
Conclusion:
We suggest a more individualized treatment based on exact delineation of the disease.
