ASO Authors Reflections: Vaginectomy as Surgical Treatment of Recurrent Cervical Cancer

Excerpt

The natural history of cervical cancer predicts that vaginal involvement is the most common occurrence in local relapse.1 Most patients with disease recurrence are initially diagnosed with advanced disease and, therefore, not amenable to radiotherapy salvage treatment due to previous intense pelvic radiotherapy regimens. This large population of patients is currently directed to demolitive procedures, such as pelvic exenteration (PE), laterally extended endopelvic resection (LEER), or laterally extended pelvic resection (LEPR).2^–4 These procedures involve an acceptable but considerably reduced quality of life (QoL) outcome for the surviving patients. However, the intense focus of referral centers on a close follow-up should allow for early diagnosis of small tumors at time of relapse. Moreover, the negative experience acquired on adverse effects of radiotherapy in patients previously treated with surgery 3 led us to investigate the possible role of nondemolitive surgery (i.e., vaginectomy) as opposed to PE on selected patients affected by an isolated vaginal disease.5 …