E. Senkus et al., Second lower genital tract squamous cell carcinoma following cervical cancer - A clinical study of 46 patients, ACT OBST SC, 79(9), 2000, pp. 765-770
Background. Patients after treatment for cervical cancer have increased ris
k of developing second squamous cell malignancy of the lower genital tract.
Material and methods. A retrospective study of 46 patients with second lowe
r genital tract epidermoid cancers following previous treatment for invasiv
e cervical carcinoma.
Results. Patient age at diagnosis of cervical cancer was 27 to 68 years (me
dian 44 years) and at diagnosis of the second malignancy - 43 to 72 years (
median 63 years). There were four cases (9%) of synchronous cancers. Time s
pan between metachronous malignancies ranged from 66 to 406 months (median
206 months). In 32 cases (70%) second lesion was located in the vagina and
in 14 (30%) - in the vulva. Out of 35 previously irradiated patients, in 24
(69%) second tumor was located within the high dose volume and in 11 (31%)
- outside it. Treatment of second cancer consisted of surgery in 12 patient
s (26%), radiotherapy - in 23 (50%), combined surgery and radiotherapy - in
five (11%), chemotherapy - in four (9%) and surgery plus chemotherapy - in
one case. Median survival was 52 months and five-year survival from the di
agnosis of second malignancy - 47.5%. No prognostic factors for survival we
re identified.
Conclusion. Treatment outcome in patients with second lower genital tract c
arcinoma is unsatisfactory due to poor feasibility of another definite trea
tment after previous radical surgery and/or radiotherapy.