Cervical, vaginal and vulvar intraepithelial neoplasms

Mitrovic-Jovanovic, Ana; B, Stanimirović; Bonaci-Nikolic, Branka; Zamurovic, M; Perisić, Z; Pantic-Aksentijevic, Snezana

doi:10.2298/vsp1112051m

Cited by 9 publications

(5 citation statements)

References 25 publications

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“…3,4 In situ and invasive vaginal cancer share many of the same risk factors as cervical cancer, such as tobacco use, younger age at coitarche, HPV and multiple sexual partners. [5][6][7] In fact, higher rates of vaginal cancer are observed in patients with a previous diagnosis of cervical cancer or cervical intraepithelial neoplasia. 7,8 As is true for other gynaecologic malignancies, vaginal cancer diagnosis and staging rely primarily on clinical evaluation by the International Federation of Gynecology and Obstetrics (FIGO).…”

mentioning

confidence: 99%

Primary vaginal cancer: role of MRI in diagnosis, staging and treatment

Gardner¹,

Jalan²,

Klopp³

et al. 2015

BJR

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mentioning

confidence: 99%

Primary vaginal cancer: role of MRI in diagnosis, staging and treatment

Gardner¹,

Jalan²,

Klopp³

et al. 2015

BJR

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“…High-grade VaIN (VaIN 2/3, vaginal HSIL) is most often found in association with previous or current cervical neoplasia, 49 and is cytologically and histologically identical to that of the vulva and cervix. Cytology focuses on increased nuclear to cytoplasmic ratio with irregular hyperchromatic nuclei.…”

Section: Methodsmentioning

confidence: 99%

The European Society of Gynaecological Oncology (ESGO), the International Society for the Study of Vulvovaginal Disease (ISSVD), the European College for the Study of Vulval Disease (ECSVD), and the European Federation for Colposcopy (EFC) Consensus Statement on the Management of Vaginal Intraepithelial Neoplasia

Kesić

Carcopino

Preti

et al. 2023

J Low Genit Tract Dis

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The European Society of Gynaecological Oncology (ESGO), the International Society for the Study of Vulvovaginal Disease (ISSVD), the European College for the Study of Vulval Disease (ECSVD), and the European Federation for Colposcopy (EFC) developed consensus statements on pre-invasive vulvar lesions in order to improve the quality of care for patients with vaginal intraepithelial neoplasia (VaIN). The management of VaIN varies according to the grade of the lesion: VaIN 1 (low grade vaginal squamous intraepithelial lesions (SIL)) can be subjected to follow-up, while VaIN 2–3 (high-grade vaginal SIL) should be treated. Treatment needs individualization according to the patient’s characteristics, disease extension and previous therapeutic procedures. Surgical excision is the mainstay of treatment and should be performed if invasion cannot be excluded. Total vaginectomy is used only in highly selected cases of extensive and persistent disease. Carbon dioxide (CO 2 ) laser may be used as both an ablation method and an excisional one. Reported cure rates after laser excision and laser ablation are similar. Topical agents are useful for persistent, multifocal lesions or for patients who cannot undergo surgical treatment. Imiquimod was associated with the lowest recurrence rate, highest human papillomavirus (HPV) clearance, and can be considered the best topical approach. Trichloroacetic acid and 5-fluorouracil are historical options and should be discouraged. For VaIN after hysterectomy for cervical intraepithelial neoplasia (CIN) 3, laser vaporization and topical agents are not the best options, since they cannot reach epithelium buried in the vaginal scar. In these cases surgical options are preferable. Brachytherapy has a high overall success rate but due to late side effects should be reserved for poor surgical candidates, having multifocal disease, and with failed prior treatments. VaIN tends to recur and ensuring patient adherence to close follow-up visits is of the utmost importance. The first evaluation should be performed at 6 months with cytology and an HPV test during 2 years and annually thereafter. The implementation of vaccination against HPV infection is expected to contribute to the prevention of VaIN and thus cancer of the vagina. The effects of treatment can have an impact on quality of life and result in psychological and psychosexual issues which should be addressed. Patients with VaIN need clear and up-to-date information on a range of treatment options including risks and benefits, as well as the need for follow-up and the risk of recurrence.

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“… ЦИТОЛОГИЧЕСКОЕ, ГИСТОПАТОЛОГИЧЕСКОЕ И ИММУНОГИСТОХИМИЧЕСКОЕ ИССЛЕДОВАНИЕ У пациенток, у которых сохранена шейка матки, обнаружение диспластических клеток плоского эпителия на слизистой влагалища не обязательно указывает на наличие VaIN или аденоза, поскольку возможен заброс клеток из шейки матки [36]. Гистологический диагноз показывает аномалию созревания плоского эпителия по крайней мере на две трети пути вверх от базальной мембраны.…”

Section:  микробиом влагалищаunclassified

Key Points of the European Communities Consensus Statement on the Treatment of Vaginal Intraepithelial Neoplasia

Матылевич,

Тарасов,

Шелкович

et al. 2023

Репродуктивное Здоровье. Восточная Европа

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С целью улучшения качества оказания медицинской помощи пациенткам с вагинальной интраэпителиальной неоплазией (VaIN) Европейское общество гинекологической онкологии (ESGO), Международное общество по изучению вульвовагинальных заболеваний (ISSVD), Европейская коллегия по изучению заболеваний вульвы (ECSVD) и Европейская федерация кольпоскопии (EFC) разработали консенсусные заявления по лечению инвазивных поражений вульвы. Подходы к лечению VaIN варьируют в зависимости от степени поражения: VaIN 1 (плоскоклеточное интраэпителиальное поражение (SIL) низкой степени) может подвергаться наблюдению, тогда как VaIN 2/3 (вагинальный SIL высокой степени) следует лечить. Лечение требует индивидуализации в соответствии с особенностями пациента, распространенностью заболевания и предшествующими лечебными воздействиями. В статье обсуждаются методы хирургического лечения, лазеротерапии, применение местного лечения имиквимодом, а также брахитерапии. Подчеркнута высокая тенденция VaIN к рецидивированию и необходимость обеспечения приверженности пациентов к регулярным контрольным визитам. Рекомендованы сроки и объем последующего динамического наблюдения. To improve the quality of care for patients with vaginal intraepithelial neoplasia (VaIN), the European Society of Gynecological Oncology (ESGO), the International Society for the Study of Vulvovaginal Diseases (ISSVD), the European College for the Study of Vulvar Diseases (ECSVD) and the European Federation of Colposcopy (EFC) have developed consensus statements for the treatment of invasive vulvar lesions. Treatment of VaIN varies depending on the extent of the lesion: VaIN 1 (vaginal squamous intraepithelial lesions (SIL) low-grade) may be observed, whereas VaIN 2/3 (high-grade vaginal SIL) should be treated. Treatment requires individualization according to patient characteristics, disease extent, and previous therapeutic treatments. The article discusses methods of surgical treatment, laser therapy, the use of local treatment with imiquimod, and brachytherapy. The high tendency of VaIN to recur and the need to ensure patient adherence to careful follow-up visits are emphasized. The timing and scope of follow-up are recommended.

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Cervical, vaginal and vulvar intraepithelial neoplasms

Abstract: nem

Cited by 9 publications

References 25 publications

Primary vaginal cancer: role of MRI in diagnosis, staging and treatment

Primary vaginal cancer: role of MRI in diagnosis, staging and treatment

Key Points of the European Communities Consensus Statement on the Treatment of Vaginal Intraepithelial Neoplasia

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