Vagina

Question 1

Choose all correct statements regarding vaginal cancer.

a) The most common age group is the 7th decade of life.
b) Squamous cell type accounts for the majority of primary vaginal cancers
c) Most vaginal cancers are secondary metastases with endometrial cancer being the most common primary
d) 30% of women diagnosed with primary cervical cancer have a previous history of in situ or invasive cervical cancer

Answer 1

a) true
b) true 70-80%
c) false -cervical cancer is the most common primary (but most vaginal cancers are mets)
d) true

Question 2

Which of the following are true regarding vaginal cancer?

a) the most common presenting complaint is pruritis
b) most common location is the upper 1/3rd of vagina at apex or posterior wall
c) Vaginal cancer is staged surgically
d) less than 1/3 of patients at presentation have disease limited to the vagina

Answer 2

a) false -painless bleeding and discharge
b) true
c) false -clinically
d) true

Question 3

What are the most common patterns of spread for vaginal cancer?

Answer 3

direct extension
lymphatic to pelvics then para-aortic (distal 1/3rd of vagina can go to inguinofemorals)
hematogenous (lungs, liver, bone)

Question 4

Which of the following are true regarding vaginal cancer?

a) surgery is the most common primary treatment
b) surgical management necessarily involves a full exenteration
c) risk of significant complication from primary radiation therapy is 10-15%
d) 5 year survival is greater than 80%

Answer 4

a) false -rads
b) false -upper vaginectomy/radical hysterectomy possible if no bowel/bladder involvement in stage 1 disease
c) true -fistula, radiation cystitis, radiation proctitis
d) false 50%