Shah et al identified risk factors affecting mortality in a woman with vaginal cancer. These can help to identify a woman who may benefit from more aggressive management. The authors are from the University of Washington at Seattle.
Patient selection: woman with vaginal cancer
Risk factors for HPV-related squamous cell carcinoma:
(1) starting intercourse at a young age
(2) greater number of lifetime sexual partners
(3) failure to use protection
(4) cigarette smoking
(5) exposure to high risk strains of HPV
Risk factors for mortality:
(1) high stage (Stage III or IV)
(2) size > 4 cm
(3) melanoma or clear cell carcinoma associated with diethylstilbesterol exposure
Reduced mortality is associated with appropriate, modern management. Early disease that can be cured by surgery has the best survival.
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