Primary vaginal sarcoma in a single center (143)

Abstract

<b>Objectives:</b> Primary vaginal sarcomas are rare, easily recurrent tumors with an unknown etiology. We aimed to investigate the clinical characteristics and prognosis of primary vaginal sarcoma. <b>Methods:</b> A retrospective analysis was conducted on patients with primary vaginal sarcoma treated at our center from 2000 to 2020. <b>Results:</b> A total of 15 patients were identified. Of these, nine (60.0%) patients had leiomyosarcoma, two (13.3%) patients had Ewing's sarcoma, two (13.3%) patients had rhabdomyosarcoma, one (6.7%) patient had undifferentiated sarcoma, and one (6.7%) patient had malignant peripheral schwannoma. The median age of the patients was 48 years (range: 29-66 years). Nine patients presented with vaginal mass which was the most common primary symptoms. Eleven patients received their primary surgery at our institution or an outside institution, seven of them received postoperative adjuvant chemotherapy or radiation therapy. The remaining four patients received initial chemotherapy and/or radiotherapy because of advanced-stage disease. The FIGO 2009 distribution by stage was: stage I in ten patients, stage II in one patient, stage III in two patients, and stage IV in two patients. The median follow-up was 43.7 months (range: 10.1-137.5 months). Thirteen patients had disease extent during follow-up, with 12 developed local relapse or adjacent organ metastases, the remaining one patient developed liver metastases during follow up. Ten of them relapsed within two years after diagnosis. Eight patients with local recurrence received a secondary surgery treatment, and only two of them relapsed again. Five patients died during follow-up; 2-year OS and 5-year OS were 80.0% and 66.7%, respectively. Patients with leiomyosarcoma or other sarcomas had the same 5-year OS (74.1% vs 66.7%, <i>p</i>=0.307). <b>Conclusions:</b> Primary vaginal sarcomas are aggressive neoplasms with different presenting characteristics. Surgery is the main treatment for primary vaginal sarcoma and local relapse vaginal sarcoma.