Use of CO2 Laser Vaporization for the Treatment of High-Grade Vaginal Intraepithelial Neoplasia

Perrotta, Myriam; Marchitelli, Claudia; Velazco, Andrea F.; Tauscher, Patricia; Lopez, G Rodriguez; Peremateu, Maria S.

doi:10.1097/lgt.0b013e318259a3ec

Cited by 24 publications

(30 citation statements)

References 17 publications

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“…Each of these methods has advantages and disadvantages and many authors have reported good results, particularly using laser vaporization [17,21,23]. CO 2 laser vaporization is successful in up to 95% of cases and is associated with a low rate of periand postoperative morbidity [24].…”

Section: Discussionmentioning

confidence: 99%

“…In contrast to standard surgical procedures (Metzenbaum scissors and scalpel), a high-magnification CO 2 laser can cut tissue with little bleeding and achieves an optimal, uniform cutting depth with preservation of the excised specimen [20,21]. We therefore hypothesized that selected patients with high-risk VaIN would benefit from a novel treatment procedure involving colposcopic-guided laser-skinning colpectomy.…”

Section: Introductionmentioning

confidence: 99%

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Laser-skinning colpectomy for extended vaginal intraepithelial neoplasia and microinvasive cancer

Luyten

Hastor

Vasileva

et al. 2014

Gynecologic Oncology

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Laser-skinning colpectomy for extended vaginal intraepithelial neoplasia and microinvasive cancer

Luyten

Hastor

Vasileva

et al. 2014

Gynecologic Oncology

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“…Carbon dioxide-laser vaporization is the most commonly used ablative procedure, with a cure rate from 50% to 100%. 13,16 The main advantage is the possibility to control exactly the depth and width of destruction, and a rapid posttreatment healing is reported. 17 Moreover, it can be performed as an outpatient procedure and it is suitable for multifocal lesions.…”

Section: Discussionmentioning

confidence: 99%

“…17 Moreover, it can be performed as an outpatient procedure and it is suitable for multifocal lesions. 4 Recently, Perrotta et al 16 have proposed CO 2 -laser vaporization for the initial treatment of vaginal HSIL, reporting a cure rate of 86% (95% CI = 63.7%-97%). However, the small sample size (21 patients) and the short median follow-up (25 months) limited the applicability of these results.…”

Section: Discussionmentioning

confidence: 99%

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Vaginal Intraepithelial Neoplasia

Sopracordevole

Piero

Clemente

et al. 2016

Journal of Lower Genital Tract Disease

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Women diagnosed with VaIN3 should be treated with excisional procedures as first-line surgical approach, given the risk of occult invasive disease in 10% of the cases. Women diagnosed with VaIN2 and with previous hysterectomy for human papillomavirus-related cervical diseases should always be carefully evaluated and possibly excised, given the higher risk of histopathological upgrading of lesions and thus the potential risk of occult vaginal cancer. Tobacco users should be considered as high-risk group.

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

Tainio

Jakobsson

Louvanto

et al. 2016

Intl Journal of Cancer

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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.

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Use of CO2 Laser Vaporization for the Treatment of High-Grade Vaginal Intraepithelial Neoplasia

Abstract: CO2 laser vaporization was effective for the initial treatment of high-grade VaIN. However, a long-term follow-up is required due to the recurrent character of this disease.

Cited by 24 publications

References 17 publications

Laser-skinning colpectomy for extended vaginal intraepithelial neoplasia and microinvasive cancer

Laser-skinning colpectomy for extended vaginal intraepithelial neoplasia and microinvasive cancer

Vaginal Intraepithelial Neoplasia

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

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