THERAPEUTIC AND PROGNOSTIC CONSIDERATIONS IN PRIMARY-CARCINOMA OF THEVAGINA

We analyzed 46 patients with primary carcinoma of the vagina treated b etween 1969 and 1990. Median age of the patients was 67 years (range 3 3-89 years). Most (52%) of them were obese and 35% were nulliparous. F our (9%) had suffered from other gynecologic carcinoma and had been op erated six to 23 years before the current carcinoma. Forty (87%) patie nts had squamous cell carcinoma. Stage 0 (carcinoma in situ) was found in three (7%) cases and stage I-IV in 21 (54%), 10 (22%), four (9%) a nd eight (17%) cases, respectively. Most (81%) of the patients were tr eated with radiotherapy (alone or in combination with other treatments ): combination of brachytherapy and external radiotherapy were used in 45% of the cases. Surgery was used in all stage 0 cases and in 52% of stage I cases. Recurrence of the disease was found in 20 (43%) cases during the follow-up of 10 years. Most often (40%) site of the recurre nce was the vagina. Both 5- and 10-year survival were 38%. Stage and e xtent of the tumor were independent prognostic factors in stepwise mul tivariate analysis.