LASER treatment for women with high-grade vaginal intraepithelial neoplasia: A propensity-matched analysis on the efficacy of ablative versus excisional procedures

Lasers in Surgery and Medicine
Giorgio BoganiFrancesco Raspagliesi

Abstract

To investigate the long-term effectiveness of LASER treatment in women affected by high-grade vaginal intra-epithelial neoplasia. Data of consecutive women treated for high-grade vaginal intra-epithelial neoplasia were retrieved. Efficacy and long-term effectiveness of ablative and excisional procedures were tested using a propensity-matched algorithm. Risk of recurrence over the time was assessed using Kaplan-Meier and Cox models. Overall, 204 patients met the inclusion criteria. LASER ablation and exicision were performed in 169 (82.8%) and 35 (17.2%) patients. A total of 41 (20%) patients developed high-grade vaginal intraepithelial neoplasia at a median follow-up of 65 (range, 6-120) months. We observed that only HPV persistence (HR: 2.37 [95%CI:1.03, 5.42]; P = 0.04) was associated with the risk of recurrence at multivariate analysis. Seven (3.4%) invasive cancers of the lower genital tract were observed in our population. Considering the efficacy of type of procedure (after we applied the propensity-matched analysis), we observed that type of procedure did not influence persistence of HPV infection (22.8% after excision and 15.7% after ablation; P = 0.424). Similarly, recurrence (17.1% vs. 18.6%; P = 1.00) and lower genit...Continue Reading

References

Jan 26, 2011·The Oncologist·Pierre BlanchardChristine Haie-Meder
Mar 31, 2012·Journal of Lower Genital Tract Disease·Mahalakshmi Gurumurthy, Margaret E Cruickshank
Dec 12, 2012·Journal of Lower Genital Tract Disease·Myriam PerrottaMaria S Peremateu
Apr 5, 2013·BJOG : an International Journal of Obstetrics and Gynaecology·N RatnaveluR Naik
Nov 10, 2013·Obstetrics and Gynecology·Kristen P ZeligsMichael P Stany
Jan 1, 2017·European Journal of Obstetrics, Gynecology, and Reproductive Biology·Giorgio BoganiFrancesco Raspagliesi
Feb 22, 2017·Lasers in Surgery and Medicine·Yona TadirJohn Stuart Nelson
Apr 8, 2017·International Journal of Gynaecology and Obstetrics : the Official Organ of the International Federation of Gynaecology and Obstetrics·Giorgio BoganiFrancesco Raspagliesi
May 10, 2017·Journal of Minimally Invasive Gynecology·Giorgio BoganiFrancesco Raspagliesi
Sep 28, 2017·Journal of Lower Genital Tract Disease·Francesco SopracordevoleAndrea Ciavattini
Oct 7, 2017·European Journal of Obstetrics, Gynecology, and Reproductive Biology·A TranoulisN Thomakos
Nov 8, 2017·Obstetrics and Gynecology·Stephen FiasconeSarah Feldman

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Citations

Jan 9, 2020·International Journal of Gynecological Cancer : Official Journal of the International Gynecological Cancer Society·Mikel GorostidiGlauco Baiocchi
May 28, 2020·Journal of Gynecologic Oncology·Giorgio BoganiFrancesco Raspagliesi
Feb 12, 2019·Journal of Gynecologic Oncology·Giorgio BoganiFrancesco Raspagliesi
Jul 1, 2020·International Journal of Clinical Practice·Argirios RountisDimitrios Haidopoulos
Sep 26, 2020·Applied Optics·Yefei MaoLei Wang
Oct 18, 2020·Lasers in Medical Science·Laura BuggioEdgardo Somigliana
Sep 15, 2020·The Journal of Obstetrics and Gynaecology Research·Yu K ChaiKaren K L Chan
Oct 5, 2020·Gynecologic Oncology·Yoshihide InayamaKenzo Kosaka

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