High-grade vaginal intraepithelial neoplasia and recurrence risk: analysis of an Italian regional referral center series

Purpose The main aim of this study was to investigate the long-term risk of disease recurrence in women treated for high-grade vaginal intraepithelial neoplasia (HG-VaIN). Methods We conducted a retrospective analysis on a cohort of 82 women diagnosed with HG-VaIN between 2010 and 2021 at the Regional Referral Center for Prevention, Diagnosis and Treatment of HPV-related Genital Disorders , Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy. All women underwent either ablative treatment (CO2 laser ablation or electrocoagulation) or cold-knife excision. Results In our series, the recurrence rate following treatment was 17%. The 5-year cumulative probability of recurrence was 30.4% and the median time to recurrence was 15.5 months. None of the patients progressed to invasive vaginal cancer during follow-up. A concomitant cervical or vulvar intraepithelial lesion was significatively associated with an increased risk of recurrence (p = 0.006). Conclusions The results of our study suggest that women with HG-VaIN are at high risk of developing disease recurrence after treatment, especially patients with a concomitant cervical or vulvar intraepithelial lesion. In these women strict monitoring is mandatory to obtain an early identification of recurrence.

Automated summary

The aim of this study was to investigate the long-term risk of disease recurrence in women treated for high-grade vaginal intraepithelial neoplasia (HG-VaIN). A retrospective analysis was conducted on a cohort of 82 women diagnosed with HG-VaIN between 2010 and 2021 in Milan, Italy. The results showed a recurrence rate of 17%, with a 5-year cumulative probability of recurrence of 30.4% and a median time to recurrence of 15.5 months. None of the patients developed invasive vaginal cancer during follow-up. The presence of concomitant cervical or vulvar intraepithelial lesion was significantly associated with an increased risk of recurrence. Therefore, strict monitoring is necessary for early identification of recurrence in these women.