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Vulval and Vaginal Cancer

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Book cover Management of Gynecological Cancers in Older Women

Abstract

Vulvar and vaginal carcinomas are primarily cancers of the elderly. Vulvar carcinomas are treated and staged surgically with adjuvant therapy consisting of radiation therapy in the majority of cases. Conversely, vaginal carcinomas are typically treated with radiation therapy, with surgery being utilized in select cases. This chapter will review epidemiology, diagnosis, and treatment of vulvar and vaginal carcinomas, with a focus on the effect of treatment on elderly women affected by these cancers.

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References

  1. Barton DP. Treatment-related morbidity in vulvar cancer. Best Pract Res Clin Obstet Gynaecol. 2003;17(4):683–701.

    Article  PubMed  Google Scholar 

  2. Beller U, Sideri M, Maisonneuve P. Carcinoma of the vagina. J Epidemiol Biostat. 2001;6: 141–52.

    PubMed  CAS  Google Scholar 

  3. Boyce J, Fruchter RG, Kasambilides E, Nicastri AD, Sedlis A, Remy JC. Prognostic factors in carcinoma of the vulva. Gynecol Oncol. 1985;20:364–77.

    Article  PubMed  CAS  Google Scholar 

  4. Bouchardy C, Rapiti E, Blagojevic S, Vlastos A-T, Vlastos G. Older female cancer patients: importance, causes, and consequences of undertreatment. J Clin Oncol. 2007;25(14):1858–69.

    Article  PubMed  Google Scholar 

  5. Chyle V, Zagras GK, Wheeler JA, Wharton JT, Delclos L. Definitive radiotherapy for ­carcinoma of the vagina: outcome and prognostic factors. Int J Radiat Oncol Biol Phys. 1996;35:891–905.

    Article  PubMed  CAS  Google Scholar 

  6. Creasman WT, Phillips JL, Menck HR. The national cancer data base report on cancer of the vagina. Cancer. 1998;83:1033–40.

    Article  PubMed  CAS  Google Scholar 

  7. Dupont J, Sovak MA, Benjamin I, Spriggs D. Chemotherapeutic agents used in the treatment of gynecologic malignancies. In: Rubin S, editor. Chemotherapy of gynecologic cancers. Philadelphia: Lippincott Williams & Wilkins; 2004. p. 23–5.

    Google Scholar 

  8. Eifel PJ, Morris M, Burke TW, Levenback C, Gersehnson DM. Prolonged continuous infusion cisplatin and 5-fluorouracil with radiation for locally advanced carcinoma of the vulva. Gynecol Oncol. 1995;59:51–6.

    Article  PubMed  CAS  Google Scholar 

  9. Elkas JC, Berek JS. Vulvar cancer: clinical manifestations, diagnosis, and pathology. Available from: http://www.uptodate.com/contents/vulvarcancer-clinical-manifestations-diagnosis-and-pathology. Accessed on June 2011.

  10. Gershenson DM, McGuire WP, Gore M, Quinn MA, Thomas G. Gynecologic cancer-controversies in management. 1st ed. Edinburgh: Elsevier Limited; 2004.

    Google Scholar 

  11. Gerszten KM, Selvaraj RN, Kelley J, Faul C. Preoperative chemoradiation for locally advanced carcinoma of the vulva. Gynecol Oncol. 2005;99:540–644.

    Article  Google Scholar 

  12. Ghebre RG, Posthuma R, Vogel RI, Geller MA, Carson LF. Effect of age and comorbidity on the treatment and survival of older patients with vulvar cancer. Gynecol Oncol. 2011;121(3):595–9.

    Article  PubMed  Google Scholar 

  13. Ghia AJ, Gonzalez VJ, Tward JD, Stroup AM, Pappas L, Gaffney DK. Primary vaginal cancer and chemoradiotherapy. Int J Gynecol Cancer. 2011;21:378–84.

    Article  PubMed  Google Scholar 

  14. Greater Metropolitan Clinical Taskforce. Vulvar cancer. In: Best clinical practice gynaecological cancer guidelines 2009. Available from: http://www.health.nsw.gov.au/resources/gmct/gynaeonc/pdf/go_clinical_guidelines.pdf. Accessed on June 2011.

  15. Grigsby PW. Vaginal cancer. Curr Treat Options Oncol. 2002;3:125–30.

    Article  PubMed  Google Scholar 

  16. Homesley HD. Management of vulvar cancer. Cancer. 1995;76 Suppl 10:2159–70.

    Article  PubMed  CAS  Google Scholar 

  17. Homesley HD, Bundy BN, Sedlis A, Adcock L. Radiation therapy versus pelvic node resection for carcinoma of the vulva with positive groin nodes. Obstet Gynecol. 1986;68(6):733–40.

    PubMed  CAS  Google Scholar 

  18. Homesley HD, Bundy BN, Sedlis A, Yordan E, Berek JS, Jahshan A. Prognostic factors for groin node metastasis in squamous cell carcinoma of the vulva (a Gynecologic Oncology Group study). Gynecol Oncol. 1993;49:279–83.

    Article  PubMed  CAS  Google Scholar 

  19. Hyde SE, Ansink AC, Burger M, Schilthuis MS, Van der Velden J. The impact of performance status on survival in patients of 80 years and older with vulvar cancer. Gynecol Oncol. 2002;84:388–93.

    Article  PubMed  Google Scholar 

  20. Jemal A, Siegel R, Xu J, Ward E. Cancer statistics: 2010. CA Cancer J Clin. 2010;60(5): 277–300.

    Article  PubMed  Google Scholar 

  21. Keys HM, Bundy BN, Stehman FB. Cisplatin, radiation and adjuvant hysterectomy compared with radiation and adjuvant hysterectomy for bulky stage IB cervical carcinoma. N Engl J Med. 1999;340:1154–61.

    Article  PubMed  CAS  Google Scholar 

  22. Kirkbride P, Fyles A, Rawlings GA. Carcinoma of the vagina: experience at the Princess Margaret Hospital. Gynecol Oncol. 1995;56:435–43.

    Article  PubMed  CAS  Google Scholar 

  23. Kosary CL. FIGO stage, histology, histologic grade, age and race as prognostic factors in determining survival for cancers of the female gynecological system: an analysis of 1973–87 SEER cases of cancers of the endometrium, cervix, ovary, vulva and vagina. Semin Surg Oncol. 1994;10:31–46.

    Article  PubMed  CAS  Google Scholar 

  24. Kumar S, Shah JP, Bryant CS, Imudia AN, Morris RT, Malone JM. A comparison of younger vs older women with vulvar cancer in the United States. Am J Obstet Gynecol. 2009; 200:e.52–9.

    Article  Google Scholar 

  25. Mak RH, Halasz LM, Tanaka CK, Ancukiewicz M, Schultz DJ, Russell AH, et al. Outcomes after radiation therapy with concurrent weekly platinum-based chemotherapy or every 3–4-week 5-fluorouracil-containing regimens for squamous cell carcinoma of the vulva. Gynecol Oncol. 2011;120(1):101–7.

    Article  PubMed  CAS  Google Scholar 

  26. Montana G, Thomas G, Moore D, Saxer A, Mangan C, Lentz S, et al. Preoperative chemo-radiation for carcinoma of the vulva with N2/N3 nodes: a Gynecologic Oncology Group study. Int J Radiat Oncol Biol Phys. 2000;48(4):1007–13.

    Article  PubMed  CAS  Google Scholar 

  27. Morris M, Eifel PJ, Lu J. Pelvic radiation with concurrent chemotherapy compared with pelvic and para-aortic radiation for high risk cervical cancer. N Engl J Med. 1999;340:1137–43.

    Article  PubMed  CAS  Google Scholar 

  28. Moore DH. Chemotherapy and radiation therapy in the treatment of squamous cell carcinoma of the vulva: are two therapies better than one? Gynecol Oncol. 2009;113:379–83.

    Article  PubMed  Google Scholar 

  29. Moore DH, Thomas GM, Montana GS, Saxer A, Gallup DG, Olt G. Preoperative chemoradiation for advanced vulvar cancer: a phase II study of the Gynecologic Oncology Group. Int J Radiat Oncol Biol Phys. 1998;42(1):79–85.

    Article  PubMed  CAS  Google Scholar 

  30. Rose PG, Bundy BN, Watkins EB. Concurrent chemotherapy and pelvic radiotherapy and chemotherapy for locally advanced cervical cancer. N Engl J Med. 1999;340:1144–53.

    Article  PubMed  CAS  Google Scholar 

  31. Samant R, Lau B, Choan E, Le T, Tam T. Primary vaginal cancer treated with concurrent chemoradiation using cis-platinum. Int J Radiat Oncol Biol Phys. 2007;69:746–50.

    Article  PubMed  CAS  Google Scholar 

  32. Snijders-Keilholz T, Trimbos JB, Hermans J, Leer JW. Management of vulvar carcinoma radiation toxicity, results and failure analysis in 44 patients (1980–1989). Acta Obstet Gynecol Scand. 1993;72(8):668–73.

    Article  PubMed  CAS  Google Scholar 

  33. Stock RG, Chen AS, Seski J. A 30 year experience in the management of primary carcinoma of the vagina: analysis of prognostic factors and treatment modalities. Gynecol Oncol. 1995;56:45–52.

    Article  PubMed  CAS  Google Scholar 

  34. Surveillance Epidemiology and End Results [Internet]. Available from: http://seer.cancer.gov/statfacts/html/vulva.html. Accessed on June 2011.

  35. Thigpen JT, Blessing JA, Homesley HD, Berek JS, Creasman WT. Phase II trial of cisplatin in advanced or recurrent cancer of the vagina: a gynecologic oncology group study. Gynecol Oncol. 1986;23:101–4.

    Article  PubMed  CAS  Google Scholar 

  36. Thomas GM, Dembro AJ, Bryson SCP, Osbourne R, DePetrillo AD. Review: changing concepts in the management of vulvar cancer. Gynecol Oncol. 1991;42:9–21.

    Article  PubMed  CAS  Google Scholar 

  37. Thomas G, Dembro A, DePetrillo A, Pringle J, Ackerman P, Bryson P, et al. Concurrent radiation and chemotherapy in vulvar carcinoma. Gynecol Oncol. 1989;34:263–7.

    Article  PubMed  CAS  Google Scholar 

  38. Tranchand B, Laporte S, Glehen O, Freyer G. Pharmacology of cytotoxic agents: a helpful tool for building dose adjustment guidelines in the elderly. Crit Rev Oncol Hematol. 2003;48:199–214.

    Article  PubMed  Google Scholar 

  39. Vlastos A-T, Usel M, Beffa V, Petignat P, Neyrou-Caspar I, Bouchardy C, et al. Treatments patterns of vulvar cancer in the elderly. Surg Oncol. 2004;13:187–91.

    Article  PubMed  Google Scholar 

  40. Wasil T, Lichtman SM. Clinical pharmacology issues relevant to the dosing and toxicity of chemotherapy drugs in the elderly. Oncologist. 2005;10:602–12.

    Article  PubMed  Google Scholar 

  41. Whitney CW, Sause W, Bundy BN. Randomized comparison of fluorouracil plus cisplatin versus hydrozyurea as an adjunct to radiation therapy in stage IIB-IVA carcinoma of the cervix with negative para-aortic lymph nodes. J Clin Oncol. 1999;17:1339–48.

    PubMed  CAS  Google Scholar 

  42. Zanetta G, Lissoni A, Gabriele A. Intense neoadjuvant chemotherapy with cisplatin and epirubicin for advanced or bulky cervical and vaginal adenocarcinoma. Gynecol Oncol. 1997;64:431–5.

    Article  PubMed  CAS  Google Scholar 

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Correspondence to Amina Ahmed M.D., M.S. .

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Nadkarni, N., Ahmed, A. (2013). Vulval and Vaginal Cancer. In: Lichtman, S., Audisio, R. (eds) Management of Gynecological Cancers in Older Women. Springer, London. https://doi.org/10.1007/978-1-4471-4605-6_19

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  • DOI: https://doi.org/10.1007/978-1-4471-4605-6_19

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