Incidence of vaginal intraepithelial neoplasia after hysterectomy for cervical intraepithelial neoplasia: a retrospective study.
OBJECTIVE
Hysterectomy with concomitant cervical intraepithelial neoplasia (CIN), is often considered a definitive treatment for CIN, but development of subsequent vaginal intraepithelial neoplasia (VAIN) is known to range from 0.9% to 6.8%.


METHODS
In a retrospective analysis of 3030 women with CIN2+ without history of VAIN in the University Hospital Gasthuisberg, Leuven, Belgium, from January 1989 until December 2003, we identified 125 women who underwent a hysterectomy within 6 months after diagnosis of CIN2+ and reviewed their postoperative Papanicolaou smears.


RESULTS
Thirty-one patients (24.8%) were lost to follow-up. Seven of the 94 women in the follow-up group (7.4%) developed VAIN2+, of which 2 were invasive vaginal cancers. Median interval between hysterectomy and diagnosis of VAIN2+ was 35 months (5-103 months). Women with recurrence were significantly older (P = .003).


CONCLUSIONS
Hysterectomy may not be considered as a definitive therapy for CIN2+ because the incidence rate of subsequent VAIN2+ is as high as 7.4%.
Schockaert
Silke
S
Department of Obstetrics and Gynecology, University Hospital Gasthuisberg, Catholic University Leuven, Leuven, Belgium.
Poppe
Willy
W
Arbyn
Marc
M
Verguts
Tom
T
Verguts
Jasper
J
D000328:Adult; D000368:Aged; D002278:Carcinoma in Situ / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000379:methods; D008875:Middle Aged; D009378:Neoplasms, Multiple Primary / Q000453:epidemiology*; D012189:Retrospective Studies; D002583:Uterine Cervical Neoplasms / Q000601:surgery*; D014625:Vaginal Neoplasms / Q000453:epidemiology*; D002578:Uterine Cervical Dysplasia / Q000601:surgery*