Vaginal adenocarcinoma (including DES-associated clear cell adenocarcinoma): lines of therapy
5 standard-of-care settings across 5 lines and 1 biomarker subgroup. Rows come from the cancer page's standard of care; the grid places each on its line and subgroup.
| Line | All comers |
|---|---|
| Screening, prevention and diagnosis | 1 |
| Early / localised | 1 |
| Locally advanced | 1 |
| Advanced, first line | 1 |
| Other settings | 1 |
Screening, prevention and diagnosis
| Subgroup | Setting | Approach | Products and trials | Guideline | Evidence |
|---|---|---|---|---|---|
| All comers | Diagnosis | Biopsy with immunohistochemistry to exclude metastasis; MRI and PET-CT staging; DES exposure history. | NCCN Guidelines: Vaginal Cancer | 95 |
Early / localised
| Subgroup | Setting | Approach | Products and trials | Guideline | Evidence |
|---|---|---|---|---|---|
| All comers | Early stage | Radical vaginectomy or radical hysterectomy with lymphadenectomy, with vaginal reconstruction and ovarian preservation where appropriate; adjuvant radiotherapy for close margins or positive nodes. | NCCN Guidelines: Vaginal Cancer | 93 |
Locally advanced
| Subgroup | Setting | Approach | Products and trials | Guideline | Evidence |
|---|---|---|---|---|---|
| All comers | Locally advanced disease | External beam radiotherapy with brachytherapy, with concurrent cisplatin by extrapolation from cervical cancer. | NCCN Guidelines: Vaginal Cancer | 93 |
Advanced, first line
| Subgroup | Setting | Approach | Products and trials | Guideline | Evidence |
|---|---|---|---|---|---|
| All comers | Recurrent or metastatic disease | Platinum-based chemotherapy (carboplatin and paclitaxel); checkpoint inhibitors for mismatch-repair-deficient or PD-L1-positive tumours; pelvic exenteration for isolated central recurrence. | NCCN Guidelines: Vaginal Cancer | 98 |
Other settings
| Subgroup | Setting | Approach | Products and trials | Guideline | Evidence |
|---|---|---|---|---|---|
| All comers | DES-exposed women | Lifelong annual gynaecological examination with cytology of the cervix and vagina and colposcopy of adenosis. | NCCN Guidelines: Vaginal Cancer | 40 |
Lines and subgroups are parsed from the setting text of each standard-of-care row and can misclassify an unusual phrasing; the row’s own setting is always shown. Guideline chips reflect the NCCN category and ESMO-MCBS grade recorded on the cancer page, checked on its stated date. Not medical advice.