Treatment of vaginal recurrence in endometrial cancer

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Abstract
Background. We have reviewed the literature concerning vaginal recurrence in endometrial cancer with emphasis on prognostics and therapeutic results. Compared to the overall outcome of recurrences (11-17 per cent survive more than 3-19 years) the survival rate of strictly vaginal recurrence appears significantly higher (up to 60-70 per cent survive more than 5 years). However, the prognosis deteriorates significantly in cases where recurrences prove to be more widespread. Other factors towards predicting a poor outcome are high age, high stage, high grade, detection of papillary carcinoma, rapid recurrence, location to the lower part of vagina, large tumorsize, and previous radiation. Methods. Different methods of initial treatment and cross-relations between most prognostic factors renders any ranking of prognostic factors almost impossible. Results. Standard treatment of vaginal recurrence including combined external and intra vaginal radiation used for decades have been unable to improve survival rate. Conclusion. We suggest a more individualized treatment based on exact delineation of the disease.