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« Back to Contents VULVAR CANCER
LiFE re
Literature for ENYGO
Preinvasive disease of vulva and vagina (etiology, diagnosis,
management, follow-up)
Editor Kamil Zalewski Jentschke et al. retrospectively characterised the clinical presenta-
tion of 65 patients with VaIN and demonstrated that 55 % of lesions
Descriptive summary were found in the upper vaginal third and 42 % were multifocal.
They also reported a high relapse rate and a high progression rate
Lawrie et al. used Cochrane methodology to perform meta-analyses to invasive cancer especially if high-risk (HR) HPV positive was
on medical and surgical interventions for the treatment of usual-type detected.
vulval intraepithelial neoplasia (uVIN). They reported that imiquimod
or cidofovir may effectively treat about half of uVIN cases after a Koeneman et al., in their questionnaire-based study, assessed
16-week course of treatment. There is currently no evidence on awareness and attitudes of gynaecologists regarding imiquimod for
how medical treatment compares with surgical treatment. Women VaIN and cervical intraepithelial neoplasia treatment.
who undergo surgical treatment for uVIN have about a 50 % chance
of the condition recurring one year later. Multifocal uVIN lesions Youn et al. reported a case of refractory VaIN3 in the vaginal vault
are at a higher risk of recurrence and progression. If occult cancer that was successfully treated with a total vaginectomy.
is suspected despite a biopsy diagnosis of uVIN, surgical excision
remains the treatment of choice. If occult cancer is not a concern,
treatment needs to be individualised. The authors concluded that
combined modalities may hold the key to optimal treatment of this
complex disease.
The ISSVD Terminology Committee presented their final version of
vulvar squamous intraepithelial lesions. It contains the following:
a) Low-grade SIL of the vulva or vulvar LSIL, encompassing flat con-
dyloma or human papillomavirus effect. b) High-grade SIL or vulvar
HSIL (which was termed “vulvar intraepithelial neoplasia usual type”
in the 2004 ISSVD terminology). 3) Vulvar intraepithelial neoplasia,
differentiated type.
Grimm et al. analysed sexual activity (SA) and sexual function (SF)
of women with VIN and VSCC that had undergone vulvar surgery.
The patients showed a remarkably high SA rate of 75 %. Although
SF was notably impaired, both groups presented similar activity
and function with a tendency towards better SF in the VIN group.
Authors concluded that gynaecologists should inform about possible
consequences of surgical treatment and discuss alternative topical
treatment options especially for VIN.
Zhang et al. retrospectively reviewed records of 152 patients with
vaginal intraepithelial neoplasia (VaIN) and demonstrated that
88.2 % of patients were HPV positive, 62.0 % of patients with VaIN1
regressed spontaneously. 36.8 % and 38.5 % of patients with VaIN2
and VaIN3 that underwent treatment experienced recurrence or
progression, retrospectively.
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International Journal of Gynecological Cancer, Volume 26, Supplement #1