Risk factors for recurrence of vaginal intraepithelial neoplasia in the vaginal vault after laser vaporization.
BACKGROUND
We sought to investigate risk factors for recurrence of vaginal intraepithelial neoplasia (VAIN) in the vaginal vault after laser vaporization.


METHODS
Among 162 patients treated with laser vaporization in the vaginal vault after hysterectomy between March 1998 and August 2007, the clinical data of 68 patients were reviewed retrospectively. They underwent hysterectomy before laser vaporization due to the International Federation of Gynecology and Obstetrics (FIGO) stage Ia1-Ib1 cervical cancer (n = 17), cervical carcinoma in situ (CIS, n = 18), cervical intraepithelial neoplasia (CIN) (CIN I, n = 4; CIN II, n = 9; CIN III, n = 12), leiomyoma (n = 5) and endometrial polyp (n = 3). All patients were diagnosed as VAIN I (n = 24), VAIN II (n = 18) and VAIN III (n = 26) in the vaginal vault before laser vaporization. Risk factors for recurrence of VAIN in the vaginal vault after laser vaporization were investigated by multivariate logistic regression analysis.


RESULTS
The median age was 48 years (range, 32-74 years), and the median duration of follow-up was 33 months (range, 10-115 months). Among all patients, 18 (26.5%) showed disease recurrence. Age (< or =48 years) and VAIN III in the vaginal vault before laser vaporization were risk factors for recurrence after laser vaporization (age < or =48 years, adjusted OR, 2.07, 95% CI, 1.18-7.01; VAIN III in the vaginal vault before laser vaporization, adjusted OR, 8.42, 95% CI, 1.63-18.56).


CONCLUSIONS
Laser vaporization may be a feasible method for the treatment of VAIN in the vaginal vault after hysterectomy. However, age (< or =48 years) and VAIN III in the vaginal vault before laser vaporization should be considered as risk factors for recurrence after laser vaporization.
Kim
Hee Seung
HS
Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul 110-744, Republic of Korea.
Park
Noh Hyun
NH
Park
In-Ae
IA
Park
Ju Hee
JH
Chung
Hyun Hoon
HH
Kim
Jae Weon
JW
Song
Yong Sang
YS
Kang
Soon-Beom
SB
D000328:Adult; D017677:Age Distribution; D000367:Age Factors; D000368:Aged; D002278:Carcinoma in Situ / Q000473:pathology / Q000601:surgery*; D015897:Comorbidity; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000706:statistics & numerical data; D015994:Incidence; D053685:Laser Therapy / Q000706:statistics & numerical data*; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology*; D030361:Papillomavirus Infections / Q000453:epidemiology; D012307:Risk Factors; D014625:Vaginal Neoplasms / Q000473:pathology / Q000601:surgery*; D014626:Vaginal Smears