Vaginal cancer surgery: Difference between revisions
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==Overview== | ==Overview== | ||
The surgical approach for vaginal cancer requires a radical hysterectomy, upper vaginectomy, and bilateral pelvic lymphadenectomy. If a hysterectomy has been performed previously, then radical vaginectomy and bilateral lymphadenectomies should be done to complete the surgical therapy. Patients with stage I vaginal cancer appear to have the best outcomes when treated surgically. Early-stage disease had a mean five-year survival rate of 77 percent, which was far better than those with later-stage disease, regardless of whether or not adjuvant RT was administered | The surgical approach for vaginal cancer requires a radical hysterectomy, upper vaginectomy, and bilateral pelvic lymphadenectomy. If a hysterectomy has been performed previously, then radical vaginectomy and bilateral lymphadenectomies should be done to complete the surgical therapy. Patients with stage I vaginal cancer appear to have the best outcomes when treated surgically. Early-stage disease had a mean five-year survival rate of 77 percent, which was far better than those with later-stage disease, regardless of whether or not adjuvant RT was administered. | ||
==Surgical therapy== | |||
*Surgical excision is the mainstay of vaginal cancer treatment. This approach permits histologic diagnosis, a significant advantage over other treatments since invasive foci have been detected in up to 10 to 28 percent of specimens<ref name="pmid3191050">{{cite journal |vauthors=Ireland D, Monaghan JM |title=The management of the patient with abnormal vaginal cytology following hysterectomy |journal=Br J Obstet Gynaecol |volume=95 |issue=10 |pages=973–5 |date=October 1988 |pmid=3191050 |doi= |url=}}</ref>. | |||
*Surgical approaches include local excision, partial vaginectomy, and, rarely, total vaginectomy for extensive and persistent disease (see "Vaginectomy"). Most excisions are performed transvaginally, although at times an open or minimally invasive abdominal approach is necessary. Presurgical administration of topical therapy may reduce lesion size, allow loosening of epithelial-stromal adherence, and enable VaIN to be stripped from the underlying tissue during local excision [14]. Partial vaginectomy is required when VaIN is buried in posthysterectomy suture recesses, as these lesions are frequently inaccessible to other forms of treatment. | |||
==References== | ==References== | ||
Revision as of 13:15, 30 January 2019
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Overview
The surgical approach for vaginal cancer requires a radical hysterectomy, upper vaginectomy, and bilateral pelvic lymphadenectomy. If a hysterectomy has been performed previously, then radical vaginectomy and bilateral lymphadenectomies should be done to complete the surgical therapy. Patients with stage I vaginal cancer appear to have the best outcomes when treated surgically. Early-stage disease had a mean five-year survival rate of 77 percent, which was far better than those with later-stage disease, regardless of whether or not adjuvant RT was administered.
Surgical therapy
- Surgical excision is the mainstay of vaginal cancer treatment. This approach permits histologic diagnosis, a significant advantage over other treatments since invasive foci have been detected in up to 10 to 28 percent of specimens[1].
- Surgical approaches include local excision, partial vaginectomy, and, rarely, total vaginectomy for extensive and persistent disease (see "Vaginectomy"). Most excisions are performed transvaginally, although at times an open or minimally invasive abdominal approach is necessary. Presurgical administration of topical therapy may reduce lesion size, allow loosening of epithelial-stromal adherence, and enable VaIN to be stripped from the underlying tissue during local excision [14]. Partial vaginectomy is required when VaIN is buried in posthysterectomy suture recesses, as these lesions are frequently inaccessible to other forms of treatment.