SOFT-TISSUE SARCOMA OF THE VAGINA AND VULVA - A CLINICOPATHOLOGICAL STUDY

Objective: To review the clinicopathologic characteristics of vulvovag inal soft-tissue sarcomas, and to correlate these variables with respo nse to treatment. Methods: We performed a retrospective review of the records of 24 women treated at Memorial Hospital for sarcoma of either the vulva or vagina over 20 years (1974-1993). Archival pathology spe cimens were reviewed to confirm the diagnosis, histology, and grade of the tumor. Results: Fifteen patients had sarcomas arising from the va gina and nine had primary vulvar tumors. Leiomyosarcoma was the most c ommon histology (n = 13). Twenty-three of 24 women underwent surgical excision as their primary therapy. Twenty-three were available for fol low-up, and 16 of them (70%) are free of disease at a median follow-up time of 47 months (range 12-156, mean 59). Five women died of progres sive disease and two are currently alive with persistent or recurrent disease. Grade was the most important predictor of outcome; all seven women with low-grade tumors are alive without evidence of disease. Con clusion: Soft-tissue sarcomas are rare tumors of the lower genital tra ct. The primary therapy is surgical; adjuvant radiation therapy is ind icated for high-grade tumors and locally recurrent low-grade sarcomas.