Creasman W T, Phillips J L, Menck H R
Department of Obstetrics and Gynecology, Medical University of South Carolina, Charleston, USA.
Cancer. 1998 Sep 1;83(5):1033-40.
This study was conducted to determine practice patterns in the management of vaginal malignancy.
The National Cancer Data Base (NCDB), a large central registry of hospital case data, was reviewed for the 10-year period 1985-1994 for patients registered with a primary diagnosis of vaginal cancer. Patients with a prior history of malignancy were excluded.
Between 1985-1994 4885 cases of vaginal cancer were submitted to NCDB. More than 90% were epithelial neoplasia with approximately 25% of these in situ lesions only. Squamous carcinoma was more common as the age of the patient progressed. Adenocarcinomas represented nearly all the carcinomas in the group of patients age < 20 years and were observed less frequently with advanced age. Relative survival at 5 years was stage-related: Stage 0: 96%; Stage I: 73%; Stage II: 58%; and Stages III-IV: 36%. Melanoma had an extremely poor prognosis with a 5-year survival rate of only 14%. A significant number of sarcomas occurred in children for whom chemotherapy played a major role in treatment. Chemotherapy was used less frequently in the older patients. Survival was better in the younger patients (90% vs. 30% in the older patients).
Although vaginal cancer is the rarest of genital malignancies, it appears that treatment and results from the NCDB reported from multiple institutions followed prescribed treatment guidelines.
本研究旨在确定阴道恶性肿瘤的治疗模式。
对国家癌症数据库(NCDB)进行回顾,该数据库是一个大型的医院病例数据中央登记处,回顾了1985年至1994年这10年间初诊为阴道癌的患者。排除有恶性肿瘤病史的患者。
1985年至1994年间,4885例阴道癌病例被提交至NCDB。超过90%为上皮性肿瘤,其中约25%仅为原位病变。随着患者年龄的增长,鳞状细胞癌更为常见。腺癌几乎占所有年龄<20岁患者的癌症病例,且随着年龄增长其发病率降低。5年相对生存率与分期相关:0期:96%;I期:73%;II期:58%;III-IV期:36%。黑色素瘤预后极差,5年生存率仅为14%。相当数量的肉瘤发生在儿童中,化疗在其治疗中起主要作用。老年患者化疗使用频率较低。年轻患者生存率更高(90%对老年患者的30%)。
尽管阴道癌是最罕见的生殖器恶性肿瘤,但似乎多个机构向NCDB报告的治疗及结果遵循了规定的治疗指南。