Vaginal Cancer: From Pathology to Treatment

A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Cancer Therapy".

Deadline for manuscript submissions: closed (15 August 2024) | Viewed by 4141

Special Issue Editor


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Guest Editor
Evangelisches Krankenhaus Kalk gGmbH, Koln, Germany
Interests: gynecological oncology; surgical gynecological oncology

Special Issue Information

Dear Colleagues,

Primary vaginal carcinoma is one of the rarest neoplasms. Worldwide, about 18,000 new cases are documented each year, which corresponds to one per thousand out of all cancers and 1% of all gynaecological cancers. Expressed differently, just as many women develop vaginal carcinoma as men develop breast cancer. However, about 8000 deaths per year worldwide are attributed to vaginal cancer. This indicates that both morbidity and mortality are not negligible. Like most rare diseases, though, the situation with regard to randomised trials or larger collectives is very poor.

The vaginal intraepithelial neoplasia and vaginal carcinoma are usually associated with HPV infection. Age, inflammatory diseases, immunodeficiency and cigarette smoking have been described as risk factors for this disease complex. Due to the HPV association, vaginal neoplasms are also associated with other neoplasms of the vulva and anal canal, and therapies for these may already have been advanced. Besides radical surgery, radiotherapy is one of the most important pillars of oncological therapy. However, these measures are often associated with serious negative effects on the patient's quality of life and morbidity.

In this Special Issue, you will find recent research on pathological, translational and clinical aspects of vaginal neoplasms. We look forward to receiving original research papers and reviews on these relevant, rare topics for all vaginal precancerous lesions and malignancies, their prognosis and possible treatment options.

Dr. Dirk Michael Forner
Guest Editor

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Keywords

  • Vaginal cancer
  • Vaginal intrapitelial neoplasia
  • epidemiology
  • management
  • sentinel node
  • radiotherapy
  • chemoradiation
  • recurrent disease
  • prevention
  • quality of life

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Published Papers (2 papers)

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Research

12 pages, 1185 KiB  
Communication
Investigating the Local Effectiveness of Carbon Ion Radiotherapy for Unresectable Female Genital Tract Melanomas: A Preliminary Real-World Study
by Amelia Barcellini, Giulia Fontana, Alessandro Vai, Giovanni Damiano Aletti, Alexandra Charalampopoulou, Silvia Chiellino, Antonino Ditto, Fabio Landoni, Laura Deborah Locati, Giorgia Mangili, Fabio Martinelli, Federica Piccolo, Jessica Franzetti, Sara Imparato, Francesco Raspagliesi and Ester Orlandi
Cancers 2024, 16(24), 4147; https://doi.org/10.3390/cancers16244147 - 12 Dec 2024
Cited by 2 | Viewed by 1452
Abstract
Background/Objectives: Primary gynecological melanomas are rare malignancies with lower survival rates compared to cutaneous melanomas. Both preclinical and clinical data support the evidence that mucosal melanomas are photon-radioresistant but responsive to carbon ion radiotherapy (CIRT). The aim of this study is to [...] Read more.
Background/Objectives: Primary gynecological melanomas are rare malignancies with lower survival rates compared to cutaneous melanomas. Both preclinical and clinical data support the evidence that mucosal melanomas are photon-radioresistant but responsive to carbon ion radiotherapy (CIRT). The aim of this study is to assess, in a real-world cohort, the effectiveness and tolerability of radical CIRT in patients with inoperable gynecological mucosal melanoma. Methods: This is a real-world study aimed to assess the effectiveness and the safety of CIRT in this setting. We defined as the primary endpoints the objective response rate (ORR) and the clinical benefit (CB). The secondary endpoints included the actuarial local control rate (LC) assessed after 1 year and 2 years and the toxicity scored according to CTCAE v.5. Actuarial outcomes were analyzed using the Kaplan–Meier method, while potential predictors were investigated through the Log-rank test. Results: Between 2017 and 2023, eleven Caucasian patients underwent pelvic CIRT (total dose 68.8 GyRBE) for mucosal malignant melanoma of the vulva or the vagina. With a median follow-up of 18 months, we observed an ORR of 82% and a CB of 100%. LC at 1 and 2 years was 100% and 86%, respectively, and among the factors analyzed for their potential impact on LC, age < 60 years seems to be a potential predictor (p = 0.014). The treatment was well tolerated, with only one case of acute grade 3 erythema and, in the late phase, one case of grade 3 erythema and grade 3 urethral toxicity. Conclusions: CIRT was effective and safe for gynecological melanomas. Larger collaborative cohort studies and longer follow-ups are needed to take a step forward in comprehending the correct management of this disease. Full article
(This article belongs to the Special Issue Vaginal Cancer: From Pathology to Treatment)
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13 pages, 2156 KiB  
Article
Cytology and HPV Co-Testing for Detection of Vaginal Intraepithelial Neoplasia: A Retrospective Study
by Frederik A. Stuebs, Anna K. Dietl, Martin C. Koch, Werner Adler, Carol Immanuel Geppert, Arndt Hartmann, Antje Knöll, Grit Mehlhorn, Matthias W. Beckmann, Carla E. Schulmeyer, Felix Heindl, Julius Emons, Anja Seibold, Annika S. Behrens and Paul Gass
Cancers 2023, 15(18), 4633; https://doi.org/10.3390/cancers15184633 - 19 Sep 2023
Cited by 3 | Viewed by 2030
Abstract
(1) Background: Vaginal intraepithelial neoplasia (VaIN) is a rare premalignant disease caused by persistent human papillomavirus (HPV) infection. Diagnosing VaIN is challenging; abnormal cytology and positive HPV tests are usually the first signs, but published data on their accuracy for detecting it are [...] Read more.
(1) Background: Vaginal intraepithelial neoplasia (VaIN) is a rare premalignant disease caused by persistent human papillomavirus (HPV) infection. Diagnosing VaIN is challenging; abnormal cytology and positive HPV tests are usually the first signs, but published data on their accuracy for detecting it are rare and contradictory. The aim of this study is to compare the results of hrHPV and cytology co-testing with the histological findings of the vagina. (2) Methods: In the certified Dysplasia Unit at Erlangen University Hospital, cytology and HPV samples from the uterine cervix or vaginal wall after hysterectomy were obtained between 2015 and 2023 and correlated with histological findings in biopsies from the vaginal wall. Women without vaginal biopsy findings or concomitant cervical disease were excluded. (3) Results: In all, 279 colposcopies in 209 women were included. The histological results were: benign (n = 86), VaIN I/vLSIL (n = 116), VaIN II/vHSIL (n = 41), VaIN III/vHSIL (n = 33), and carcinoma (n = 3). Accuracy for detecting VaIN was higher in women with previous hysterectomies. Positive HPV testing during colposcopy increased the likelihood for VaIN II/III/vHSIL threefold. The detection rate for VaIN III/vHSIL was 50% after hysterectomy and 36.4% without hysterectomy. (4) Conclusions: Women with risk factors for VaIN, including HPV-16 infection or prior HPV-related disease, need careful work-up of the entire vaginal wall. Hysterectomy for HPV-related disease and a history of cervical intraepithelial neoplasia (CIN) also increased the risk for VaIN II/III/vHSIL. Full article
(This article belongs to the Special Issue Vaginal Cancer: From Pathology to Treatment)
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