SQUAMOUS-CELL CARCINOMA OF THE VAGINA - A REPORT OF 32 CASES

Between 1982 and 1992, 32 patients with squamous cell vaginal cancer w ere treated. Fourteen patients had stage I, 11 stage II, two stage III and five stage IV disease. The mean age of stage I and II patients wa s 64, of stage III and IV patients 73. Six patients were pessary-beari ng, two had a total procidentia, eight had been treated for cervical i ntraepithelial neoplasia (CIN), one for cervical cancer and one for vu lvar cancer 5-21 years before diagnosis. One patient had had external irradiation for endometrial cancer 15 years before. Nine patients had no follow-up examinations after treatment for CIN, for vulvar cancer o r after insertion of a pessary. In 14 patients doctors' or patients' d elays were considerable. Most patients presented with vaginal discharg e or bleeding, and urinary symptoms. Various treatment modalities were used. The selected patients who could be treated by surgery did best. Only patients with a stage I tumor or a stage II tumor with a diamete r of at most 30 mm survived. Tumor stage and tumor diameter were the i mportant prognostic factors. No patient died of disease after 33 month s. Failure in obtaining local control was the usual cause of death. Re commendations for prevention or early diagnosis are formulated.