Risk factors for recurrence of vaginal intraepithelial neoplasia in the vaginal vault after laser vaporization

Abstract

Background: We sought to investigate risk factors for recurrence of vaginal intraepithelial neoplasia (VAIN) in the vaginal vault after laser vaporization.

Materials and methods: Among 162 patients treated with laser vaporization in the vaginal vault after hysterectomy between March 1998 and August 2007, the clinical data of 68 patients were reviewed retrospectively. They underwent hysterectomy before laser vaporization due to the International Federation of Gynecology and Obstetrics (FIGO) stage Ia1-Ib1 cervical cancer (n = 17), cervical carcinoma in situ (CIS, n = 18), cervical intraepithelial neoplasia (CIN) (CIN I, n = 4; CIN II, n = 9; CIN III, n = 12), leiomyoma (n = 5) and endometrial polyp (n = 3). All patients were diagnosed as VAIN I (n = 24), VAIN II (n = 18) and VAIN III (n = 26) in the vaginal vault before laser vaporization. Risk factors for recurrence of VAIN in the vaginal vault after laser vaporization were investigated by multivariate logistic regression analysis.

Results: The median age was 48 years (range, 32-74 years), and the median duration of follow-up was 33 months (range, 10-115 months). Among all patients, 18 (26.5%) showed disease recurrence. Age (< or =48 years) and VAIN III in the vaginal vault before laser vaporization were risk factors for recurrence after laser vaporization (age < or =48 years, adjusted OR, 2.07, 95% CI, 1.18-7.01; VAIN III in the vaginal vault before laser vaporization, adjusted OR, 8.42, 95% CI, 1.63-18.56).

Conclusion: Laser vaporization may be a feasible method for the treatment of VAIN in the vaginal vault after hysterectomy. However, age (< or =48 years) and VAIN III in the vaginal vault before laser vaporization should be considered as risk factors for recurrence after laser vaporization.