HPV-related vulvar intraepithelial neoplasia: Outcome of different management modalities

Abstract Objective: To evaluate the outcome of various management schemes for HPV-related vulvar intraepithelial neoplasia (VIN, usual type). Methods: Retrospective chart review of patients with histologically diagnosed grade 2/3-VIN who had at least one year of follow-up. The variables that were co...

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Published inInternational journal of gynecology and obstetrics Vol. 99; no. 1; pp. 23 - 27
Main Authors Bruchim, I, Gotlieb, W.H, Mahmud, S, Tunitsky, E, Grzywacz, K, Ferenczy, A
Format Journal Article
LanguageEnglish
Published Shannon Elsevier Ireland Ltd 01.10.2007
Elsevier Science
Subjects
Adjuvants, Immunologic - therapeutic use
Adult
Aged
Aminoquinolines - therapeutic use
Biological and medical sciences
Carcinoma in Situ - therapy
Carcinoma in Situ - virology
Catheter Ablation - methods
Female
Follow-Up Studies
Gynecology. Andrology. Obstetrics
HPV
Humans
Laser Therapy - methods
Medical sciences
Middle Aged
Obstetrics and Gynecology
Outcome
Papillomavirus Infections - complications
Precancerous Conditions - therapy
Precancerous Conditions - virology
Retrospective Studies
Treatment
Treatment Outcome
VIN
Vulvar Neoplasms - therapy
Vulvar Neoplasms - virology
VIN
Treatment
Outcome
HPV
Prognosis
Gynecology
Vulva
Papovaviridae
Obstetrics
Papillomavirus
Virus
Human papillomavirus
Clinical management
Evolution
Intraepithelial neoplasia
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Summary:Abstract Objective: To evaluate the outcome of various management schemes for HPV-related vulvar intraepithelial neoplasia (VIN, usual type). Methods: Retrospective chart review of patients with histologically diagnosed grade 2/3-VIN who had at least one year of follow-up. The variables that were collected included patient characteristics, management modalities, and clinical outcome. Results: Fifty patients with a median age of 45 years old were evaluated. The median duration of follow-up was 43.5 months (12–186). Complete response (CR) and partial response occurred in 28 (56%) and 4 (8%), respectively. Nineteen of 28 patients with CR recurred with VIN. Surgical excision yielded higher CR (77%) than did either ablational techniques (21–33%) or topical immunotherapy (33%). Conclusion: In this experience, surgical excision for VIN, usual type, resulted in better therapeutic success rates than other treatment modalities. Management schemes should be individualized based on extent of disease and patient compliance.
Bibliography:ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
content type line 23
ISSN:0020-7292
1879-3479
DOI:10.1016/j.ijgo.2007.03.023