title: Vulvar intraepithelial neoplasia:  evaluation of treatment modalities.
abstract: OBJECTIVE
  The study aimed to evaluate effectiveness and recurrence rate of vulvar intraepithelial neoplasia (VIN) treatment according to treatment modalities as follows: imiquimod (Aldara), laser ablation, laser excision, wide local excision, and skinning vulvectomy. It also aimed to analyze risk factors associated to VIN recurrence.
  
  
  METHODS
  Between January 1997 and December 2010, 29 women were treated and followed up for VIN in our center. Demographics, risk factors, treatment modality, effectiveness, and recurrence data were recorded retrospectively. Study analysis used Student t test and χ2 test.
  
  
  RESULTS
  The median age was 52 years (range = 22-77 years); 52% were smokers, 31% were immunosuppressed, and 34% had concomitant or previous lower genital tract dysplasia. Of all patients, 38% had laser ablation, 31% had laser excision, 24% had wide local excision, and 3% had vulvectomy and imiquimod, with 86.2% overall effectiveness and 20% recurrence (2 laser excision and 2 wide local excision), within a mean of 35 months.
  
  
  CONCLUSIONS
  Excisional treatment has diagnostic and treatment advantages in VIN lesions. The goal is to prevent development of invasive vulvar cancer while preserving normal vulvar anatomy and function.
authors.affiliation: Maternity Dr. Alfredo da Costa, Lisbon, Portugal. filipacribeiro@gmail.com
authors.forename: Filipa
authors.initials: F
authors.lastname: Ribeiro
authors.forename: Ana
authors.initials: A
authors.lastname: Figueiredo
authors.forename: Tereza
authors.initials: T
authors.lastname: Paula
authors.forename: Jorge
authors.initials: J
authors.lastname: Borrego
mesh_terms: D000287:Administration, Topical; D000328:Adult; D000368:Aged; D000634:Aminoquinolines / Q000627:therapeutic use*; D001707:Biopsy, Needle; D002278:Carcinoma in Situ / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery*; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D013509:Gynecologic Surgical Procedures / Q000379:methods; D006801:Humans; D000077271:Imiquimod; D007150:Immunohistochemistry; D053685:Laser Therapy / Q000379:methods*; D054020:Lasers, Gas / Q000627:therapeutic use; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology / Q000469:parasitology; D009367:Neoplasm Staging; D011174:Portugal; D012189:Retrospective Studies; D018570:Risk Assessment; D016896:Treatment Outcome; D014846:Vulvar Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery*; D055815:Young Adult
chemical_list: D000634:Aminoquinolines; D000077271:Imiquimod