Vaginal cancer surgery

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 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][2].
• Surgical approaches include local excision, partial vaginectomy, and, rarely, total vaginectomy for extensive and persistent disease^[3].
• Most excisions are performed transvaginally, although at times an open or minimally invasive abdominal approach is necessary^[4].
• Presurgical administration of topical therapy may reduce lesion size, allow loosening of epithelial–stromal adherence, and enable cancer cells to be stripped from the underlying tissue during local excision^[5].
• Partial vaginectomy is required when VaIN is buried in post-hysterectomy suture recesses, as these lesions are frequently inaccessible to other forms of treatment^[6].