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학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
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연구자들이 자신의 연구와 전문성을 널리 알리고, 새로운 협력의 기회를 만들 수 있는 네트워킹 공간이에요.
논문 기본 정보
- 자료유형
- 학술저널
- 저자정보
- 발행연도
- 2018.1
- 수록면
- 1 - 10 (10page)
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Objective: To evaluate the clinical outcomes of vaginal intraepithelial neoplasia (VAIN) and to assess the risk of recurrence and progression to invasive vaginal carcinoma. Methods: A retrospective review of the clinicopathologic data and clinical outcomes was performed on patients who were diagnosed with VAIN at a single center between January 2000 and July 2016. Demographics, treatments, and clinical outcomes were abstracted from medical records. Results: A total of 576 patients with VAIN1–3 were included in the study analysis. The distribution of VAIN1–3 was as follows: VAIN1 31.1%, VAIN2 45.3%, and VAIN3/carcinoma in situ (CIS) 23.6%. In VAIN1 patients, observation was performed in 29.1% of the cases and 48.8% obtained regression. In VAIN2+ patients, management included observation (3.5%), topical management (6.5%), laser ablation (75.3%), excision (14.1%), and radiotherapy (0.5%) with the following rates of recurrence/progression: 46.2%, 62.5%, 26.4%, 32.7%, and 0%, respectively. Four patients among VAIN3/CIS patients (3.2%) developed invasive vaginal cancer during the follow-up period with a median time to cancer diagnosis of 21.4 months (range, 5.0–44.8 months). On multivariate analysis, high-risk human papillomavirus (HPV) positivity and treatment method were found to be independent risk factors for recurrence and progression (p=0.003 and p=0.001). Conclusion: Patients with VAIN are at high-risk of recurrence, but the risk of progression to vaginal cancer is relatively low. Laser or excision provides higher regression rate than topical agent or observation, and high-risk HPV positivity is a risk factor for recurrence. Whatever the treatment method is used, however, the high rate of recurrence warrants long-term follow-up surveillance.
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참고문헌 (17)
참고문헌 신청
Sillman FH / 1997 / Vaginal intraepithelial neoplasia: risk factors for persistence, recurrence, and invasion and its management / Am J Obstet Gynecol 176:93~99
Dodge JA / 2001 / Clinical features and risk of recurrence among patients with vaginal intraepithelial neoplasia / Gynecol Oncol 83:363~369
Rome RM / 2000 / Management of vaginal intraepithelial neoplasia: a series of 132 cases with longterm follow-up / Int J Gynecol Cancer 10:382~390
Hodeib M / 2016 / Recurrence and risk of progression to lower genital tract malignancy in women with high grade VAIN / Gynecol Oncol 141:507~510
Jentschke M / 2016 / Clinical presentation, treatment and outcome of vaginal intraepithelial neoplasia / Arch Gynecol Obstet 293:415~419
Dodge JA / 2001 / Clinical features and risk of recurrence among patients with vaginal intraepithelial neoplasia / Gynecol Oncol 83:363~369
Rome RM / 2000 / Management of vaginal intraepithelial neoplasia: a series of 132 cases with longterm follow-up / Int J Gynecol Cancer 10:382~390
Hodeib M / 2016 / Recurrence and risk of progression to lower genital tract malignancy in women with high grade VAIN / Gynecol Oncol 141:507~510
Jentschke M / 2016 / Clinical presentation, treatment and outcome of vaginal intraepithelial neoplasia / Arch Gynecol Obstet 293:415~419
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