Primary carcinoma of the vagina: a study of 29 cases.

Twenty-nine cases of primary carcinoma of the vagina were reviewed. Vaginal carcinoma produced symptoms in 26 cases and postmenopausal bleeding was the most frequently observed symptom. Squamous carcinoma was the dominating histologic type (83%). Twelve patients had previously been treated for invasive or preinvasive cervical disease. Six patients had previously received pelvic irradiation. The median time from cervical carcinoma to vaginal carcinoma was 20 years, and from pelvic irradiation to vaginal carcinoma, 25 years. Two factors significantly influenced the results of treatment: the mode of delivery of radiation therapy and the total tumor dose. Clinical staging did not significantly influence the results of treatment although stage I patients did better than stage II-IV patients. Combination of external pelvic irradiation and brachytherapy, with a total tumor dose of 7000 R or more, was necessary to prevent local recurrence.