title: Use of CO2 laser vaporization for the treatment of high-grade vaginal intraepithelial neoplasia.
abstract: OBJECTIVE
  In a series of cases of high-grade vaginal intraepithelial neoplasia (VaIN) at our institution, to analyze its clinicopathologic characteristics, diagnostic methodology, and therapeutic results obtained with the use of CO2 laser vaporization.
  
  
  METHODS
  Between January 2003 and December 2009, 28 patients with a diagnosis of high-grade VaIN were treated in our department using CO2 laser vaporization. Of the 28 patients, 7 were lost to follow-up; 21 patients were followed up with cytological examination and colposcopy for therapeutic response. Median follow-up was 25 months (range = 12-78 months). The setting is an urban referral center, a private hospital with a high-grade complexity.
  
  
  RESULTS
  Of the 21 patients evaluated, 18 are currently disease free after having undergone a single application of CO2 laser vaporization with a cure rate of 86% (95% CI = 63.7%-97%). Three patients (14%) presented with persistence/recurrence and required a second application. Of these 3 patients, 2 are currently disease free, whereas 1 patient progressed to invasive carcinoma 11 months after a second procedure and was managed with partial colpectomy and pelvic lymphadenectomy.
  
  
  CONCLUSIONS
  CO2 laser vaporization was effective for the initial treatment of high-grade VaIN. However, a long-term follow-up is required due to the recurrent character of this disease.
authors.affiliation: Department of Gynecology, Hospital Italiano of Buenos Aires, Buenos Aires, Argentina.
authors.forename: Myriam
authors.initials: M
authors.lastname: Perrotta
authors.forename: Claudia E
authors.initials: CE
authors.lastname: Marchitelli
authors.forename: Andrea F
authors.initials: AF
authors.lastname: Velazco
authors.forename: Patricia
authors.initials: P
authors.lastname: Tauscher
authors.forename: Graciela
authors.initials: G
authors.lastname: Lopez
authors.forename: Maria S
authors.initials: MS
authors.lastname: Peremateu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002278:Carcinoma in Situ / Q000628:therapy*; D005260:Female; D006801:Humans; D054020:Lasers, Gas / Q000627:therapeutic use*; D008875:Middle Aged; D012008:Recurrence; D016896:Treatment Outcome; D014625:Vaginal Neoplasms / Q000628:therapy*; D014835:Volatilization