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. 2023 Jul;308(1):201-206.
doi: 10.1007/s00404-022-06886-6. Epub 2022 Dec 24.

High-grade vaginal intraepithelial neoplasia and recurrence risk: analysis of an Italian regional referral center series

Ermelinda Monti  1 , Giada Libutti  1 , Eugenia Di Loreto  1 , Veronica Boero  1 , Giussy Barbara  1   2 , Maria Iorio  1 , Giulia Emily Cetera  3 , Sonia Cipriani  2 , Fabio Parazzini  2
Affiliations

High-grade vaginal intraepithelial neoplasia and recurrence risk: analysis of an Italian regional referral center series

Ermelinda Monti et al. Arch Gynecol Obstet. 2023 Jul.

Abstract

Purpose: The main aim of this study was to investigate the long-term risk of disease recurrence in women treated for high-grade vaginal intraepithelial neoplasia (HG-VaIN).

Methods: We conducted a retrospective analysis on a cohort of 82 women diagnosed with HG-VaIN between 2010 and 2021 at the "Regional Referral Center for Prevention, Diagnosis and Treatment of HPV-related Genital Disorders", Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy. All women underwent either ablative treatment (CO2 laser ablation or electrocoagulation) or cold-knife excision.

Results: In our series, the recurrence rate following treatment was 17%. The 5-year cumulative probability of recurrence was 30.4% and the median time to recurrence was 15.5 months. None of the patients progressed to invasive vaginal cancer during follow-up. A concomitant cervical or vulvar intraepithelial lesion was significatively associated with an increased risk of recurrence (p = 0.006).

Conclusions: The results of our study suggest that women with HG-VaIN are at high risk of developing disease recurrence after treatment, especially patients with a concomitant cervical or vulvar intraepithelial lesion. In these women strict monitoring is mandatory to obtain an early identification of recurrence.

Keywords: Follow-up; Treatment; VaIN; Vaginal cancer.

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