Surgery should be considered for early stages of vaginal cancer. Surgery will usually be in the form of a radical hysterectomy with extirpation of the involved area of the vagina. Free margins of 2 cm are the goal. In some cases, it may be necessary to perform a more extensive surgery such as pelvic exenteration, but radiation therapy is then usually less aggressive. If significant parts of the vagina are removed, reconstruction should be considered.
Tumor localized to the inner 1/3 of the vagina
Treatment is the same as for cervical cancer which is radical surgery or radiation therapy.
Tumor localized to the posterior vaginal wall (middle and/or 1/3)
Treatment is radical surgery with posterior pelvic exenteration or radiation therapy in combination with chemotherapy.
Tumor localized to the anterior vaginal wall (middle and/or outer 1/3)
Treatment is radical surgery in the form of anterior pelvic exenteration or radiation therapy in combination with chemotherapy.
Treatment of recurrence
If the patient has previously completed full radiation therapy, further treatment is mainly surgery if the patient is considered fit. If the tumor is limited to the vagina, bladder, and/or rectum, treatment is removal of the vagina, bladder, and/or rectum.