Therapeutic effect of laser vaporization for vaginal intraepithelial neoplasia following hysterectomy due to premalignant and malignant lesions

Wang, Yan; Kong, Wei­min; Wu, Yumei; Wang, Jiandong; Zhang, Weiyuan

doi:10.1111/jog.12383

Cited by 23 publications

(43 citation statements)

References 29 publications

(41 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…HPV clearance could decrease the risk of recurrent disease. HPV persistence after laser vaporisation has been in previous studies 23–62% . In our study, HPV persistence after laser vaporisation was 67%.…”

Section: Discussionsupporting

confidence: 69%

“…Efficacy rates have been similar to that of laser vaporisation also with regard to recurrence rates, but adverse effects including chronic ulcerations after 5‐fluorourasil have been more common . Previous studies have reported 46–86% cure rates after one laser vaporisation treatment round . Our result of 70% complete histological regression with imiquimod and 90% with laser treated patients can be considered equally effective as conventional laser vaporisation.…”

Section: Discussionsupporting

confidence: 57%

“…VAIN patients often have history of cervical cancer or have immunosuppression . Recurrent VAIN lesions are common and require repeat treatments which may be mutilating and cause vaginal scarring . The most common contemporary treatment for VAIN is laser vaporisation.…”

Section: Introductionmentioning

confidence: 99%

“…3 Recurrent VAIN lesions are common and require repeat treatments which may be mutilating and cause vaginal scarring. 12,13 The most common contemporary treatment for VAIN is laser vaporisation. Previous treatments for CIN or a previous hysterectomy make it more difficult to see the lesions, take biopsies and also to treat the patients with laser or surgical approaches.…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Randomised trial on treatment of vaginal intraepithelial neoplasia—Imiquimod, laser vaporisation and expectant management

Tainio

Jakobsson

Louvanto

et al. 2016

Intl Journal of Cancer

View full text Add to dashboard Cite

Vaginal intraepithelial neoplasia (VAIN) is associated with human papillomavirus (HPV) infection. The most common treatment modality is laser vaporisation, but recurrences are common. Imiquimod is an immune response modulator which is used for the treatment of external condylomas and other HPV-related genital neoplasias. The aim of the study was to evaluate the efficacy and tolerability of vaginally administered imiquimod in comparison with laser vaporisation and expectant management of high-grade VAIN. This proof of principle pilot study was a prospective 16-week randomised trial. We enrolled 30 patients with histologically confirmed VAIN 2 or 3 into three study arms: vaginally administered imiquimod, laser vaporisation and expectant management. Follow-up colposcopy visits included high-risk human papillomavirus (hrHPV) testing, cytology and punch biopsies. At baseline 77% (n = 20/26) of the patients were hrHPV positive. HPV clearance was significantly higher in the imiquimod arm (63%, n = 5/8) than in the laser arm (11%, n = 1/9) (p = 0.05) or in the expectant management arm (17%, n = 1/6) (p = 0.138). At baseline 25 patients (83%) had VAIN 2 and five (17%) had VAIN 3. None of the lesions progressed during the follow-up. Histological regression (≤VAIN 1) was observed in 80% (n = 8/10) of patients in the imiquimod arm, 100% (n = 10/10) of the laser arm (p = 0.474) and 67% (n = 6/9) of the expectant management arm (p = 0.628). Vaginal imiquimod appears to be as effective as laser treatment in high-grade VAIN.

show abstract

Section: Discussionsupporting

confidence: 69%

Section: Discussionsupporting

confidence: 57%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Randomised trial on treatment of vaginal intraepithelial neoplasia—Imiquimod, laser vaporisation and expectant management

Tainio

Jakobsson

Louvanto

et al. 2016

Intl Journal of Cancer

View full text Add to dashboard Cite

show abstract

“…Other studies only considered histologically confirmed VAIN as relapse. A Chinese study among 28 patients with VAIN after hysterectomy (group 1) and 11 patients with VAIN due to cervical cancer (group 2) treated with laser vaporization found a regression rate of 85.7 % in group 1 and 54.5 % in group 2 [19].…”

Section: Discussionmentioning

confidence: 98%

Clinical presentation, treatment and outcome of vaginal intraepithelial neoplasia

Jentschke

Hoffmeister

Soergel

et al. 2015

Arch Gynecol Obstet

View full text Add to dashboard Cite

show abstract

Human papillomavirus and p16 in squamous cell carcinoma and intraepithelial neoplasia of the vagina

Bertoli

Rasmussen

Sand

et al. 2019

Intl Journal of Cancer

View full text Add to dashboard Cite

We estimated the overall and type‐specific prevalence of human papillomavirus (HPV) and p16 overexpression in vaginal cancer and vaginal intraepithelial neoplasia (VaIN). We conducted a systematic search of PubMed, Embase and Cochrane Library to identify studies published between 1986 and 2017 using PCR‐based or Hybrid Capture 2 tests to evaluate the presence of HPV DNA and/or using any method to detect p16 overexpression in VaIN, vaginal squamous cell carcinoma (VaSCC), or other types of vaginal cancer. Applying a random effects model, we estimated the pooled prevalence of HPV and p16 overexpression along with 95% confidence intervals (CIs). The I2 statistic was used to assess heterogeneity. We included 26 studies, reporting HPV prevalence and six studies evaluating p16 overexpression. The pooled HPV prevalences in VaSCC (n = 593) and VaIN (n = 1,374) were 66.7% (95% CI = 54.7–77.8) and 85.2% (95% CI = 78.2–91.0), respectively. Substantial inter‐study heterogeneity was observed, and analyses stratified on geographic region, type of tissue, HPV detection method or PCR primer type did not fully explain the observed heterogeneity. The most predominant HPV type among the HPV positive VaSCC and VaIN cases was HPV16, followed by HPV33, and HPV45 (in VaIN) and HPV18, and HPV33 (in VaSCC). In pooled analyses, 89.9% (95% CI = 81.7–94.6) of HPV positive and 38.9% (95% CI = 0.9–90.0) of HPV negative vaginal cancers were positive for p16 overexpression. Our findings suggest that vaccination against HPV might prevent a substantial proportion of vaginal neoplasia and highlight the need for further studies of the possible clinical value of p16 testing in these patients.

show abstract

Therapeutic effect of laser vaporization for vaginal intraepithelial neoplasia following hysterectomy due to premalignant and malignant lesions

Abstract: Laser vaporization may be a useful option for the treatment of VAIN after hysterectomy. However, a follow-up is required to assess the long-term efficacy of laser treatment.

Cited by 23 publications

References 29 publications

Randomised trial on treatment of vaginal intraepithelial neoplasia—Imiquimod, laser vaporisation and expectant management

Randomised trial on treatment of vaginal intraepithelial neoplasia—Imiquimod, laser vaporisation and expectant management

Clinical presentation, treatment and outcome of vaginal intraepithelial neoplasia

Human papillomavirus and p16 in squamous cell carcinoma and intraepithelial neoplasia of the vagina

Contact Info

Product

Resources

About