title: Risk factors for recurrent VIN. Role of multifocality and grade of disease.
abstract: OBJECTIVE
  To evaluate possible risk factors for recurrence of vulvar intraepithelial neoplasia (VIN): menopausal status, smoking, method of treatment (local excision with cold knife, CO2 laser vaporization, CO2 laser excision), grade and focality.
  
  
  METHODS
  At the dysplasia clinic of the Department of Obstetrics and Gynecology, Medical Center, Heinrich Heine University, Dusseldorf, Germany, we treated 102 patients with VIN with a mean follow-up of 3.5 years. VIN was demonstrated for all these patients by histologic examination of biopsies taken under colposcopic control. Follow-up was performed by clinical examination and colposcopy. Statistical evaluation was done by the chi 2 test.
  
  
  RESULTS
  VIN recurrence developed in 36.6% of patients. We could not prove any correlation between recurrence of disease and menopausal status, smoking behavior or treatment method used. Recurrent VIN correlated with the grade (P < .001) and focality (P < .05) of the disease.
  
  
  CONCLUSIONS
  In the prediction of possible risk of recurrence of disease, not only the grade of VIN but also the multifocality is important. Treatment should be done very carefully considering the functions of the vulva; therefore, mutilating operations ought to be avoided as much as possible.
authors.affiliation: Department of Gynecology and Obstetrics, University Hospital, Heinrich Heine University, Dusseldorf, Germany.
authors.forename: V
authors.initials: V
authors.lastname: Küppers
authors.forename: M
authors.initials: M
authors.lastname: Stiller
authors.forename: T
authors.initials: T
authors.lastname: Somville
authors.forename: H G
authors.initials: HG
authors.lastname: Bender
mesh_terms: D000328:Adult; D001706:Biopsy; D002278:Carcinoma in Situ / Q000473:pathology* / Q000601:surgery; D003127:Colposcopy; D005260:Female; D006801:Humans; D053685:Laser Therapy; D008593:Menopause; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D012307:Risk Factors; D012907:Smoking; D014846:Vulvar Neoplasms / Q000473:pathology* / Q000601:surgery