ANALYSIS OF 346 CASES OF CLEAR CELL ADENOCARCINOMA OF THE VAGINA AND CERVIX WITH EMPHASIS ON RECURRENCE AND SURVIVAL

Three hundred and forty-six cases of clear cell adenocarcinoma of the vagina and cervix have been accessioned into the Registry for Research on Transplacental Carcinogenesis. In the early 1970s these cancers reached a peak incidence which has continued on the same level up to the present. Two-thirds of the patients with a maternal history had been exposed to diethylstilbestrol (DES) or related compounds in utero. Follow-up for the periods up to 15.3 years (mean, 4.0) yielded an actuarial 5-year survival of 78%. The survival figures in cases of Stage I carcinomas of the vagina and cervix were 87 and 91%, respectively. Local excision of Stage I appeared to carry an increased risk of recurrence. The overall rate of recurrence for all cases was 23% at 5 years. Recurrences were most frequent in the pelvis and lungs. Surgical therapy, and less often, radiotherapy, resulted in the survival of 12 of the 58 patients with recurrent tumor for 3 or more years. Various cytotoxic chemotherapeutic agents were administered to 34 patients with four objective responses, but no total remissions. The details of these findings will be presented. © 1979.