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69 VAGINAL CANCER

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arunmp's version from 2016-12-16 03:42

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Question Answer
The upper two-thirds of the vagina drains to theobturator, internal, external, and common iliac nodes.
The lower one-third of the vagina may drain to theinguinofemoral nodes.
Vaginal cancer is most often found in thepost wall,sup one-third of the vagina (the speculum must berotated to ensure exam of this region).
FIGO stage includescystoscopy, and proctosigmoidoscopy in women with locally advanced Dz, CXR, LFTs, and alk phos.
Cancer involving the ----- & ----- is never considered to be a vaginal primary (even if the bulk of Dz lies in the vagina)vulva or cervix
During clinical examination search forvulva or cervix and anal canal co synchronus primary
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TREATMENT OF CA VAGINA

Question Answer
3 appropriate Tx for vaginal intraepithelial neoplasia (VAIN)Surgical excision, laser vaporization, and topical 5-FU
Up to 60% of pts with VAIN havemultifocal.So close followup needed
In general, what is the preferred definitive Tx modality for vaginal cancer?Although surgery may be appropriate for early, stage I lesions, definitive RT is generally the preferred Tx modality (as morbidity is less
For advanced III–IVAconsider ccrt (extrapolated from cervix and anal canal)
vaginal cylinder brachytherapy alone may be acceptable forpts with VAIN or very early stage I vaginal cancer <5-mmthick.
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For vaginal cancer managed with definitive RT, 5-yr pelvic Dz control and DSS
Question Answer
stages I86% and 85%
stage II84% and 78%
III–IVA71% and 58%
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Question Answer
If the lower 3rd of the vagina is involvedthen the inguinal nodes may be treated
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