Pelvic organ prolapse and vaginal cancer: A systematic literature review

Background Primary vaginal cancer is a rare gynecologic malignancy. Few cases describing the concurrence of a vaginal tumor with advanced genital prolapse are reported in the literature and there is no consensus on optimal treatment. Objectives To investigate available evidence on presentation, treatment, and outcomes of these concurrent conditions. Search Strategy We performed a systematic search of literature indexed on PubMed, Scopus, ISI Web of Science, and Cochrane using a combination of keywords and text words represented by "pelvic organ prolapse", "genital prolapse", and "vaginal cancer", "vaginal carcinoma". Selection Criteria No article type restrictions were applied. Data Collection and Analysis Twenty-one studies (case reports and two small case series) were incorporated into the review process, for a total of 27 patients. Main Results Management usually involved surgery or primary external beam radiation therapy. External beam radiation therapy was reported to be highly associated with the development of vesicovaginal fistula. A surgical approach was the treatment of choice in most cases. Exclusive interstitial brachytherapy was rarely performed. Conclusion A multidisciplinary approach considering risks and benefits is of the utmost importance to provide counseling and tailor treatment strategy in these complex cases.