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Abramson Cancer CenterNCI CANCERLIT® Search: Vaginal and Vulvar Cancer - March 2002
National Cancer Institute®
Last Modified: March 1, 2002
Table of Contents
1
UI - 11820332
AU - Akashi K; Nagasaka T; Nakashim N; Harada T; Okamoto T; Mizutani S;
TI -
Ishiko H
Squamous cell carcinoma of the vulva and adjacent lesions treated at
Nagoya University Hospital from 1965 to 1997.
SO - Nagoya J Med Sci 2001 Nov;64(3-4):109-21
AD - Department of Laboratory Medicine, and Obstetrics & Gynecology of Nagoya
University School of Medicine, Japan.
Japan has a lower incidence of vulvar squamous cell carcinoma (VSCC)
than Western nations. To pin-point the reasons for this, we reviewed
biopsy samples from all cases treated at Nagoya University Hospital over
the past 33 years in order to investigate the background lesions for
VSCC. Two of 36 VSCC patients had adjacent or coexisting lichen
sclerosus (LS), 5 had squamous cell hyperplasia (SCH), and 16 had vulvar
intraepithelial neoplasia (VIN). There were 8 cases in which these
lesions were thought to be the origin of the VSCC, 1 in which
keratinizing squamous cell carcinoma (KSC) was seen in LS, 1 in which
verrucous SCH was the origin, and 6 in which 4 basaloid carcinoma and 2
warty carcinoma developed from basaloid VIN and warty VIN, respectively.
Although 8 other cases of keratinizing or non-keratinizing squamous cell
carcinomas (NSC) coexisted with VIN NOS (not otherwise specified),
differentiated VIN or basaloid VIN, we could not be histologically
certain of the origin. Among 22 VSCC patients tested for HPV DNA, only
an 84-year-old woman presenting a histological feature of KSC tested
positive by in situ hybridization (ISH). It was considered that LS and
SCH had little and VIN considerable capacity to cause the malignancy of
VSCC. We surmise that in Japan the majority of squamous cell carcinoma
is unrelated to HPV. One reason for the low incidence of VSCC is largely
due to race; the homogeneous, monoethnic Japanese population, as well as
the few cases of HPV-related VSCC.
2
UI - 11788182
AU - Louis-Sylvestre C; Haddad B; Paniel BJ
TI -
Paget's disease of the vulva: results of different conservative
treatments.
SO - Eur J Obstet Gynecol Reprod Biol 2001 Dec 1;99(2):253-5
AD - Department of Obstetrics and Gynecology, Maternite Centre Hospitalier
Intercommunal, Intercommunal Hospital of Creteil, 40 Avenue de Verdun,
94010 Cedex, Creteil, France.
OBJECTIVE: To evaluate three conservative treatments for vulvar Paget's
disease: wide excision, laser alone, or limited surgery associated with
laser. STUDY DESIGN: A retrospective analysis of 52 patients treated
with wide excision (31 cases), limited surgery, and peripheral laser [Br
J Obstet Gynecol 1995;102:359], or laser alone [Gynecol Oncol
1975;3:46]. RESULTS: Mean time to recurrence was 1+/-0.6 years after
laser alone, 1.9+/-1.5 years after the association limited excision and
peripheral laser, and 2.7+/-1 years after wide excision alone. At 1 year
recurrence rates were 67% after laser alone, 33% after the association
laser plus surgery, and 23% after wide excision. CONCLUSION:
Conservative management preserves vulvar anatomy and function, but
recurrence rates are high.
3
UI - 11812085
AU - Daling JR; Madeleine MM; Schwartz SM; Shera KA; Carter JJ; McKnight B;
TI -
Porter PL; Galloway DA; McDougall JK; Tamimi H
A population-based study of squamous cell vaginal cancer: HPV and
cofactors.
SO - Gynecol Oncol 2002 Feb;84(2):263-70
AD - Program in Epidemiology, Division of Public Health Sciences, Fred
Hutchinson Cancer Research Center, 1100 Fairview Avenue North, Seattle,
Washington 98109-1024, USA. jdaling@fhcrc.org
BACKGROUND: Little is known about the etiology of in situ or invasive
squamous cell cancer of the vagina. It is thought that some vaginal
cancers may have the same etiology as cervical cancer. It is also not
known whether in situ and invasive vaginal cancer share the same
etiologic factors. We conducted a study to evaluate risk factors for in
situ and invasive vaginal cancer and their potential relationship to
prior exposure to human papillomaviruses (HPV). METHODS: A
population-based case-control study included 156 women with squamous
dialing in western Washington state. Cases and controls were interviewed
in person and provided blood samples; archival tumor tissue was
retrieved for cases. Blood samples were tested for antibodies to HPV,
and tumor tissue was tested for HPV DNA. RESULTS: Women with vaginal
cancer were more likely to have five or more lifetime sexual partners
(OR = 3.1, 95% CI 1.9 to 4.9), to have an early age at first intercourse
(<17 years OR = 2.0, 95% CI 1.2 to 3.5), and to be current smokers at
diagnosis (OR = 2.1, 95% CI 1.4 to 3.1) than control women.
Approximately 30% of all cases had been treated for a prior anogenital
tumor, most often of the cervix. Prior hysterectomy was a risk factor
only among women who had no history of prior anogenital cancer (OR = 3.9
95% CI 2.5 to 6.1). Antibodies to HPV16 L1 were strongly related to risk
of vaginal cancer (OR = 4.3, 95% CI 3.0 to 6.2). We detected HPV DNA in
tumor blocks from over 80% of the patients with in situ and 60% of the
patients with invasive cancers. CONCLUSIONS: In situ and invasive
vaginal neoplasia have many of the same risk factors as cervical cancer,
including a strong relationship to HPV infection. Women who have been
treated for a prior anogenital cancer, particularly of the cervix, have
a high relative risk, although low absolute risk, of being diagnosed
with vaginal cancer. (c)2002 Elsevier Science
4
UI - 11812092
AU - Tabata T; Takeshima N; Nishida H; Hirai Y; Hasumi K
TI -
Treatment failure in vaginal cancer.
SO - Gynecol Oncol 2002 Feb;84(2):309-14
AD - Department of Gynecology, Cancer Institute Hospital, 1-37-1
Kami-Ikebukuro, Toshima-ku, Tokyo 170-8455, Japan.
tabatat@gyn.jfcr.or.jp
OBJECTIVE: The aim of this study was to analyze the pattern of treatment
failure in patients with vaginal cancer. METHODS: Fifty-one patients
with primary vaginal cancer (registered between 1957 and 1995) were
reviewed. Primary treatment consisted of surgery in 12 patients and
radiation in 39 patients. In these patients, the prognosis and treatment
failure were analyzed in relation to clinicopathological factors.
RESULTS: The 5-year survival rate was 100% in stage 0 (N = 5), 82% in
stage I (N = 11), 70% in stage II (N = 23), 0% in stage III (N = 5), 14%
in stage IV (N = 7), and 61% overall (N = 51). Although early disease
had a relatively favorable prognosis, two of five patients with stage 0
disease developed local recurrence. There was no site-related difference
in survival, but survival was better when the tumor occupied less than
one-third of the vaginal wall compared with more than one-third. All
relapses in stage 0-II patients were local recurrences, whereas
treatment failure in stage III-IV patients was due to either persistent
local disease or new distant metastasis. CONCLUSION: The present
findings suggest that more intensive local therapy may achieve a better
prognosis for patients with early disease. Conversely, suppression of
distant metastasis along with aggressive local control is needed for
advanced disease. Conventional radiotherapy alone is of little value for
advanced disease. B)2002 Elsevier Science.
5
UI - 11856713
AU - Shimada K; Ohashi I; Shibuya H; Tanabe F; Akashi T
TI -
MR imaging of an atypical vaginal leiomyoma.
SO - AJR Am J Roentgenol 2002 Mar;178(3):752-4
AD - Department of Radiology, Toride Kyodo General Hospital, 2-1-1 Hongo,
Toride-shi, 302-0022 Ibaraki, Japan.
6
UI - 11849805
AU - Monk BJ; Tewari KS; Puthawala AA; Syed AM; Haugen JA; Burger RA
TI -
Treatment of recurrent gynecologic malignancies with iodine-125
permanent interstitial irradiation.
SO - Int J Radiat Oncol Biol Phys 2002 Mar 1;52(3):806-15
AD - Division of Gynecologic Oncology, The Chao Family N.C.I.-Designated
Comprehensive Cancer Center, University of California, Irvine-Medical
Center, Orange, CA 92868, USA.
PURPOSE: To analyze the outcome of permanent 125I interstitial
radiotherapy for unresectable retroperitoneal recurrences of gynecologic
malignancies. METHODS AND MATERIALS: A retrospective review of 20
patients treated between 1979 and 1993 was performed to evaluate
survival and morbidity associated with the interstitial 125I technique.
RESULTS: Nineteen tumors were located on the lateral pelvic wall and one
in the para-aortic region. Eight patients, not previously irradiated,
received external beam radiotherapy (EBRT) along with 125I interstitial
implants placed at the time of celiotomy. Nineteen (95%) are dead of
disease at 1-69 months of follow-up. The median survival was 7.7 months
for patients treated with 125I alone and 25.4 months for those treated
with both 125I and EBRT. One patient is alive without evidence of
disease 69 months after 125I implantation. Fistulas, bowel obstructions,
and fatal complications occurred only among patients previously
irradiated. CONCLUSIONS: When used in a previously irradiated field,
125I interstitial radiotherapy has major morbidity and is unlikely to be
associated with cure or long-term survival. In radiotherapy-naive
patients with unresectable isolated recurrent gynecologic malignancies,
125I implants and EBRT are feasible and occasionally may contribute to
long-term disease-free survival.
7
UI - 11793263
AU - Zbar AP; Nishikawa H; BeerGabel M
TI -
Vertical rectus abdominis myocutaneous transposition flap for total
pelvic exenteration in recurrent vulvar carcinoma invading the anus.
SO - Tech Coloproctol 2001 Apr;5(1):66
AD - Kaplan Medical Center, Rehovot, 76100 Israel. apzbar@zahav.net.il
8
UI - 11728665
AU - Abu-Musa A; Khalil A; Ghaziri G; Seoud M; Abbas J
TI -
Synchronous vulvar and breast cancer.
SO - Eur J Obstet Gynecol Reprod Biol 2001 Dec 10;100(1):92-3
AD - Department of Obstetrics and Gynecology, American University of Beirut
Medical Center, P.O. Box 113-6044-6A, Beirut, Lebanon. aa06@aub.edu.lb
Synchronous vulvar and breast cancer is rare. A 44-year-old women
presented with a lesion in the right labia majora and right upper
quadrant breast lump. After work-up, she underwent radical wide local
vulvar excision and modified radical mastectomy with axillary lymph node
dissection. The pathology of the vulva revealed
moderately-differentiated squamous cell carcinoma and that of the breast
infiltrating ductal carcinoma. Only two such cases have been previously
reported: one was an elderly patient and the second a young patient with
HIV infection. Our patient is a young and healthy woman making her
presentation a unique and rare case.
9
UI - 11857367
AU - Raitanen M; Rantanen V; Kulmala J; Pulkkinen J; Klemi P; Grenman S;
TI -
Grenman R
Paclitaxel combined with fractionated radiation in vitro: a study with
vulvar squamous cell carcinoma cell lines.
SO - Int J Cancer 2002 Feb 20;97(6):853-7
AD - Department of Obstetrics and Gynecology, University of Turku, Turku,
Finland.
Concurrent paclitaxel and radiation has given promising results in the
treatment of a variety of solid tumors. We wanted to test the efficacy
of this combination for vulvar carcinoma, which currently has a poor
outcome in advanced stages. The radiation sensitivity, sublethal damage
repair (SLDR) capacity and effect of paclitaxel during fractionated
radiation were assessed in our study on 7 vulvar inherently
radioresistant squamous cell carcinoma (SCC) cell lines. The 96-well
plate clonogenic assay was used. Survival data were fitted to the linear
quadratic model. The area under the curve (AUC), equivalent to mean
inactivation dose (D), was obtained with numerical integration. AUC
ratios between single-dose radiation and fractionated radiation with or
without paclitaxel were used to determine the SLDR of the cell lines and
the effect of paclitaxel on it. Seven currently tested vulvar SCC cell
lines were found to have a limited capacity of repairing sublethal
damage (SLD). Only 3 of them presented SLDR of significance. The effect
of concurrent radiation and paclitaxel was clearly additive when the
radiation dose was fractionated in most of the cell lines. In addition,
2 of the cell lines having SLDR exhibited a trend toward losing the
repair capacity when paclitaxel was present during the irradiation. In
addition, the survival curve of the UM-SCV-1A cell line gave the
impression of a true paclitaxel effect on SLDR. Paclitaxel used
concurrently with fractionated radiation showed effectiveness on vulvar
carcinoma. The effect was at least additive and could even be expected
to abrogate the SLDR during split-dose radiation. Copyright 2001
Wiley-Liss, Inc.
10
UI - 11855875
AU - Hyde SE; Ansink AC; Burger MP; Schilthuis MS; van der Velden J
TI -
The impact of performance status on survival in patients of 80 years and
older with vulvar cancer.
SO - Gynecol Oncol 2002 Mar;84(3):388-93
AD - Department of Obstetrics and Gynaecology, Academic Medical Centre,
Meibergdreef 9, Amsterdam, 1105 AZ, The Netherlands.
OBJECTIVE: There are no data available on the impact of performance
status on outcome in patients with vulvar cancer. It was the objective
of this study to determine the impact of performance status on survival
in a group of elderly patients. METHODS: A retrospective review of
records of patients with vulvar cancer aged 80 years or greater and
treated in a gynecological referral center was performed. Multiple
clinical and pathological variables together with performance status
were assessed and the impact on overall survival was determined both by
univariate and multivariate analysis. RESULTS: Of 75 patients aged 80
years or older, 57 (76%) had standard treatment. The patients who had
standard treatment were characterized by an earlier clinical stage and a
better performance status compared with patients who had nonstandard
treatment. When preoperatively available parameters of all patients were
assessed in relation to survival in the total group, Eastern Cooperative
Oncology Group (ECOG) performance status was the only independent
prognostic indicator for survival. When all clinical and
histopathological variables were assessed in the subgroup who had
standard treatment, both ECOG performance status and extracapsular lymph
node involvement were independent prognostic variables for overall
survival. Age was not a significant prognostic variable. CONCLUSIONS:
ECOG performance status is the only available pretreatment variable with
independent prognostic value for survival in this group of elderly
patients with vulvar cancer. These data show the importance of
individualizing the treatment of patients with vulvar cancer.
Performance status takes a more important place than age in the
management process of these patients.
11
UI - 11855880
AU - Yingna S; Yang X; Xiuyu Y; Hongzhao S
TI -
Clinical characteristics and treatment of gestational trophoblastic
tumor with vaginal metastasis.
SO - Gynecol Oncol 2002 Mar;84(3):416-9
AD - Department of Obstetrics and Gynecology, Peking Union Medical College
Hospital, Beijing, 100730, People's Republic of China.
OBJECTIVE: The aim of this study was to evaluate clinical
manifestations, management options, and prognosis for women presenting
with gestational trophoblastic tumors with vaginal metastasis. METHOD:
Fifty-one patients with vaginal metastases were analyzed retrospectively
documented by physical examination and tissue biopsy. RESULTS: The
incidence of vaginal metastasis in choriocarcinoma and invasive mole was
8.6 and 4.1%, respectively. The metastatic tumors were mostly located in
the anterior wall of the lower part of vagina. Eighteen patients
presented with hemorrhage and rupture. All patients were treated with
5-Fu combined chemotherapy. Vaginal packing was employed to stop
bleeding in 16 patients. Three of them received selective angiographic
embolization. Vaginal tumors disappeared after chemotherapy. Forty-four
patients with complete remission were followed up periodically without
evidence of recurrence. CONCLUSIONS: Large or multiple vaginal
metastases place the patients at high risk for significant hemorrhage.
5-Fu combined chemotherapy is still a reliable method for treating
vaginal metastases. Angiographic embolization is emerging as a
successful procedure to control the severe hemorrhage of vaginal tumors.
12
UI - 11855886
AU - Sliutz G; Reinthaller A; Lantzsch T; Mende T; Sinzinger H; Kainz C;
TI -
Koelbl H
Lymphatic mapping of sentinel nodes in early vulvar cancer.
SO - Gynecol Oncol 2002 Mar;84(3):449-52
AD - Department of Gynecology, University of Vienna, Vienna, A-1090, Austria.
gerhard.sliutz@akh-wien.ac.at
OBJECTIVE: The aim of the study was to determine the diagnostic accuracy
and feasibility of sentinel lymph node (SLN) detection using a gamma
local wide excision or vulvectomy including groin dissection, were
eligible for the study. Two to 3 h before the planned procedure we
injected technetium(99) m-labeled microcolloid intradermally at four
locations around the tumor. Dynamic and static images were recorded
using a gamma camera. SLN locations were marked on the overlying skin.
In the operating theater SLNs were identified at the beginning of the
procedure using a handheld gamma-detection probe. After resection of
suspected SLNs a standard unilateral or bilateral groin dissection was
performed, subsequently followed by local wide excision or, if
indicated, radical vulvectomy. Sentinel node detection using
technetium(99) m-labeled microcolloid was compared with final
histopathological and immunohistochemical results. RESULTS: Scintigraphy
showed focal uptake in all 26 patients. Intraoperatively we detected all
sentinel nodes by handheld gamma probe. In 20 patients, one sentinel
node was identified unilaterally, while in 6 patients two or more nodes
were identified bilaterally. Histologically positive SLNs were found in
9 patients. In our preliminary series we did not find any false-negative
SLN. CONCLUSION: Identification of sentinel nodes in vulvar cancer is
feasible with preoperatively administered technetium(99)m-labeled
microcolloid. We confirm the results of previous studies and improve the
evidence that the SLN procedure could be implemented in future therapy
concepts.
13
UI - 11852367
AU - Boman F; Farre I; Vinatier D; Querleu D
TI -
[A vaginal tumor]
SO - Ann Pathol 2001 Oct;21(5):447-8
AD - Anatomie et Cytologie Pathologiques, Hopital Calmette, CHRU, 59037 Lille
Cedex, France. f-boman@chru-lile.fr
14
UI - 11899127
AU - Petrow W; Gerdsen R; Uerlich M; Richter O; Bieber T
TI -
Successful topical immunotherapy of bowenoid papulosis with imiquimod.
SO - Br J Dermatol 2001 Dec;145(6):1022-3
The above citations and abstracts reflect those newly added to CANCERLIT for the month and topic listed in the title. The citations have been retrieved from CANCERLIT using a predefined search strategy of indexed subject terms. Although the search strategy has been refined as best as possible, citations may appear that are not directly related to the topic, and occasionally relevant references may be omitted.
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