[Radiotherapy of primary vaginal carcinoma and effects of histological and clinical factors on the prognosis].

434 cases of primary vaginal carcinoma were treated from 1950 to 1984 at the Irradiation Department of the University Clinic for Obstetrics and Gynecology, Vienna. The five-year survival rate for various clinical stages is as follows: Stage I 76.7%, stage II 44.5%, stage III 31%, stage IV 18.2%. In this retrospective study 110 patients seen from 1975 to 1984 were reviewed in detail and evaluated with a view toward their clinical and morphological aspects and survival rates. Patients up to the age of 60 have a five-year survival rate of 50%, those over 75 years of age reach only 34.3%. If the carcinoma was discovered in a routine check up the survival rate is 61.1%, whereas in cases with symptoms the rate decreases to 36.9%. Survival differences were also observed for patients with a carcinoma in the upper third of the vagina (61.1%) versus patients with a carcinoma in the lower third (33.3%); for patients with well-differentiated tumours (62.5%) versus patients with grades II and III (41.5% and 34.9%). It can be seen, that with brachytherapy local control of the carcinoma can be achieved with excellent results in early stages. Treatment of patients with more advanced carcinomas should include external beam therapy. The importance of gynecological screening especially for older women is emphasized.