Is there an Association between Vaginal Cancer and Genital Prolapse? A Data-Analysis and Review of Literature

Männle Heidrun, Osorio Birthe, M. Felix, M. Karsten
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Abstract

Purpose: Primary vaginal cancer represents a rare disease. The main risk factor for vaginal carcinoma is a persistent human papillomavirus (HPV) infection. However, chronic mechanic irritation of the vagina, have long been suspected to contribute to the development of vaginal cancer. This study examined to assess possible associations between genital prolapse and the incidence of vaginal cancer. Methods: We conducted a systematic literature search regarding the association between vaginal cancer and genital prolapse, supplemented with our own data set of the Centre for Gynaecological Oncology of the Ortenau Clinic Offenburg. Results: Our case analysis of prolapse-associated vaginal carcinomas corresponds to a large extent with the total collective of vaginal carcinomas. The most frequent histological subtype was squamous cell carcinoma in 90%. The median age of patients with genital prolapse-associated vaginal carcinomas was 75 years (72.9 ± 12.1 years). However prolapse associated vaginal cancers had FIGO stage IV more often than cases of vaginal cancer in general. FIGO stage I was reported as most frequent (39%). FIGO stage IV was the second most frequent stage in prolapse associated cases (25%). Furthermore, the Kaplan-Meier curves are significantly different from unselected vaginal cancer cases. In the prolapse associated cases FIGO stages I and II have a far better disease-free survival; in contrast, the prognosis in the advanced stages is much worse. Conclusion: In addition to the HPV infection, patients with genital prolapsed and those with ongoing systemic corticosteroid therapy or other immunocompromising medications, should be perceived as risk groups and regularly examined.
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阴道癌症和生殖器脱垂之间有联系吗?数据分析与文献综述
目的:原发性阴道癌是一种罕见的疾病。阴道癌的主要危险因素是持续的人乳头瘤病毒(HPV)感染。然而,长期以来,阴道的慢性机械性刺激一直被怀疑有助于阴道癌的发展。本研究旨在评估生殖器脱垂与阴道癌发病率之间可能存在的联系。方法:我们对阴道癌与生殖脱垂之间的关系进行了系统的文献检索,并辅以我们自己的奥芬堡Ortenau诊所妇科肿瘤中心的数据集。结果:我们对脱垂相关性阴道癌的病例分析在很大程度上符合阴道癌的总体情况。最常见的组织学亚型为鳞状细胞癌(90%)。脱垂相关阴道癌患者的中位年龄为75岁(72.9±12.1岁)。然而,脱垂相关的阴道癌比一般的阴道癌更常处于FIGO IV期。FIGO I期最常见(39%)。FIGO IV期是脱垂相关病例中第二常见的阶段(25%)。此外,Kaplan-Meier曲线与未选择的阴道癌病例有显著不同。在与脱垂相关的病例中,FIGO I期和II期有更好的无病生存率;相比之下,晚期的预后就差得多。结论:除了HPV感染外,生殖器脱垂患者和正在进行全身皮质类固醇治疗或其他免疫损害药物治疗的患者应被视为危险群体并定期检查。
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