Innovations in the Management of Vaginal Cancer

Kulkarni, Anjali; Dogra, Nupur; Zigras, Tiffany

doi:10.3390/curroncol29050250

Cited by 11 publications

(8 citation statements)

References 49 publications

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“…However, the role of surgery in the treatment of vaginal cancer is limited due to the proximity of the vagina to vital organs such as the bladder, urethra, and rectum ( 31 ). Therefore, surgery is considered in selected cases as follows: small early-stage tumors that are confined to the upper posterior vagina, late-stage disease with recto-vaginal or vesico-vaginal fistulas, and central recurrence after radiotherapy ( 1 , 7 , 32 ). The type of surgery varies and includes options such as local excision, partial vaginectomy, radical hysterectomy, and pelvic exenteration, usually combined with lymph node assessment.…”

Section: Discussionmentioning

confidence: 99%

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Primary vaginal cancer after hysterectomy for benign conditions: a systematic review of the literature

Qian,

Gracious,

Chen

et al. 2024

Front. Oncol.

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BackgroundPrimary vaginal cancer is a rare condition. Some studies have revealed an increased risk of vaginal cancer among patients who have undergone hysterectomy for premalignant and malignant cervical disease. However, there is limited literature available on primary vaginal cancer following hysterectomy for benign conditions.ObjectivesThis review aimed to investigate available evidence on clinical characteristics, treatments, and outcomes of primary vaginal cancer following hysterectomy for benign diseases. Additionally, we provide a case of a patient who developed primary vaginal cancer 10 years after undergoing hysterectomy for abnormal uterine bleeding.Search strategyWe conducted a comprehensive literature search on PubMed, Scopus, Web of Science using a combination of title and abstract represented by “hysterectomy”, and “vaginal cancer”; “vaginal neoplasm”; and “cancer of vagina”. No article type restrictions were applied.Main resultsEight studies with a total of 56 cases were included in this review. The main symptom observed was vaginal bleeding. Squamous cancer was found to be the most common type, followed by adenocarcinoma. The majority of vaginal cancer cases occurred approximately 10 years after undergoing hysterectomy. The most common location of the tumor was in the vaginal apex. The management approaches varied and details were available in 25 cases. Among these, 7 cases were treated with radiotherapy alone, 1 case received concurrent chemoradiation therapy, and the of rest of the cases underwent surgery as the primary treatment, with or without additional adjuvant therapy. Data of follow-up was available for 15 cases, with 2 cases resulting in death and 2 cases experiencing recurrence. The other cases were alive and well at the time of considered follow up.ConclusionPrimary vaginal cancer after hysterectomy for benign conditions is an extremely rare condition. It is essential to have high-level evidence to guide the screening and treatment strategy for this rare condition. A part of women who have undergone hysterectomy for benign disorders can benefit from vaginal cytology evaluation. It is reasonable to postpone the initial screening after surgery and to extend the interval between subsequent screenings. Further retrospective case-control trials are expected to determine which specific subgroups of patients mentioned above might most potentially benefit from screening. The treatment decision for vaginal cancer after hysterectomy is more favorable to radiotherapy-based management rather than surgery. Vaginal endometrioid adenocarcinoma may arise from the malignant transformation of endometriosis. More studies are expected to investigate the correlation between these two diseases.

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Section: Discussionmentioning

confidence: 99%

“…The most common type of primary vaginal malignancies is squamous cell carcinoma, which is usually HPV induced, accounting for 90%. Adenocarcinoma and other rare entities like melanoma, sarcoma, and lymphoma ( 6 , 7 ) are also encountered. The risk of primary vaginal cancer increases with age.…”

Section: Introductionmentioning

confidence: 99%

Primary vaginal cancer after hysterectomy for benign conditions: a systematic review of the literature

Qian,

Gracious,

Chen

et al. 2024

Front. Oncol.

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“…However, treatment should be tailored to each patient’s unique circumstances [ 17 ]. For patients with metastatic VGC, a more systematic strategy with the use of immunotherapy is being reviewed [ 18 ].…”

Section: Introductionmentioning

confidence: 99%

The Role of Urothelial Cancer-Associated 1 in Gynecological Cancers

Nousiopoulou,

Vrettou,

Damaskos

et al. 2024

CIMB

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Gynecological cancers (GC) represent some of the most frequently diagnosed malignancies in women worldwide. Long-non-coding RNAs (lncRNAs) are regulatory RNAs increasingly being recognized for their role in tumor progression and metastasis in various cancers. Urothelial cancer-associated 1 (UCA1) is a lncRNA, first found deregulated in bladder cancer, and many studies have exposed its oncogenic effects in more tumors since. However, the role of UCA1 in gynecological malignancies is still unclear. This review aims to analyze and define the role of UCA1 in GC, in order to identify its potential use as a diagnostic, prognostic, or therapeutic biomarker of GC. By employing the search terms “UCA1”, “breast cancer”, “endometrial cancer”, “ovarian cancer”, “cervical cancer”, “vaginal cancer”, and “vulvar cancer” in the PubMed database for the literature review, we identified a total of sixty-three relevant research articles published between 2014 and 2024. Although there were some opposing results, UCA1 was predominantly found to be upregulated in most of the breast, endometrial, ovarian, cervical, and vulvar cancer cells, tissue samples, and mouse xenograft models. UCA1 overexpression mainly accounts for enhanced tumor proliferation and increased drug resistance, while also being associated with some clinicopathological features, such as a high histological grade or poor prognosis. Nonetheless, no reviews were identified about the involvement of UCA1 in vaginal carcinogenesis. Therefore, further clinical trials are required to explore the role of UCA1 in these malignancies and, additionally, examine its possible application as a target for upcoming treatments, or as a novel biomarker for GC diagnosis and prognosis.

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“…Vaginal neoplasms (benign or malignant) are rare [1]. Primary vaginal cancer represents a rare malignancy of the female reproductive tract [2]. It is estimated to comprise 10% of all malignant neoplasms affecting the vagina [3] and 1-2% of all gynecological cancers [4].…”

Section: Introductionmentioning

confidence: 99%

Fibroepithelial Polyp of the Vagina With Torsion: A Difficult Diagnosis Based on Clinical and Morphological Findings of the Vaginal Lesion

Thanasa,

Kontogeorgis

et al. 2024

Cureus

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Vaginal fibroepithelial polyps are rare benign tumors of the mucosa of the anterior vaginal wall. In extremely rare cases, they may originate from the posterior vaginal wall or be complicated by torsion. Our case concerns a 63-year-old patient who presented to the gynecology outpatient clinic of the General Hospital of Trikala with minor vaginal bleeding. On vaginal examination, a large pedunculated painless hemorrhagic polypoid mass was noticed, originating from the posterior vaginal wall. A torsion of the pedunculated vaginal tumor was suspected, leading to its surgical excision with clear resection margins. Due to extensive tissue necrosis, accurate histological identification of the vaginal neoplasm was not possible. Histological examination excluded vaginal malignancy. Based predominantly on the clinical and morphological features of the vaginal lesion, a diagnosis of vaginal fibroepithelial polyp with torsion was made, acknowledging its limitations. The patient was discharged from the clinic the same afternoon following the surgery. Three months later, no recurrence of the lesion in the vaginal wall was noted. Following the case presentation, this paper provides a brief literature review of this rare entity, focusing on the diagnostic and therapeutic approaches.

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Innovations in the Management of Vaginal Cancer

Cited by 11 publications

References 49 publications

Primary vaginal cancer after hysterectomy for benign conditions: a systematic review of the literature

Primary vaginal cancer after hysterectomy for benign conditions: a systematic review of the literature

The Role of Urothelial Cancer-Associated 1 in Gynecological Cancers

Fibroepithelial Polyp of the Vagina With Torsion: A Difficult Diagnosis Based on Clinical and Morphological Findings of the Vaginal Lesion

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