title: Treatment of vulvar intraepithelial neoplasia with CO(2) laser vaporization and excision surgery.
abstract: OBJECTIVE
  To evaluate the recurrence rate after a single treatment of vulvar intraepithelial neoplasia (VIN) with CO(2) laser vaporization.
  
  
  METHODS
  Fifty women with usual-type or differentiated VIN (grades 2 and 3) treated with CO(2) laser vaporization or surgery excision (cold knife or CO(2) laser) were retrospectively evaluated.
  
  
  RESULTS
  Of the 50 patients, 41 (82.0%) had usual-type VIN and 9 (18.0%) had differentiated VIN. Moreover, 24 (48.0%) were treated with surgery excision and 26 (52.0%) underwent CO(2) laser vaporization. Laser-treated patients were significantly younger (p < .01) with more multifocal (p < .05) and multicentric lesions (p < .01) than in the surgery group. Recurrence-free survival (RFS) rates at 1 year were 91.0% for the surgery and 65.2% for the laser vaporization groups (p < .01). At 5 years, RFS rates were unchanged for the surgery group and dropped to 51.3% (p < .01) for the laser group. On the univariate analysis, current smoker (p = .03), multicentric VIN (p = .02), and laser vaporization treatment (p < .01) had a statistically significant impact on RFS. One patient progressed to invasive cancer (2%).
  
  
  CONCLUSIONS
  The recurrence rate after CO(2) laser vaporization requires regular, close, and extended monitoring.
authors.affiliation: 1Department of Oncological Surgery, Alexis Vautrin Cancer Center, 2Department of Surgery Gynecology, Regional Maternity University, 3Centre de Recherche en Automatique de Nancy (CRAN - UMR 7039), and 4Department of Biostatistics, Alexis Vautrin Cancer Center, University of Lorraine, Vandoeuvre-lès-Nancy, France.
authors.forename: Léa
authors.initials: L
authors.lastname: Leufflen
authors.forename: Pauline
authors.initials: P
authors.lastname: Baermann
authors.forename: Philippe
authors.initials: P
authors.lastname: Rauch
authors.forename: Thierry
authors.initials: T
authors.lastname: Routiot
authors.forename: Lina
authors.initials: L
authors.lastname: Bezdetnava
authors.forename: Francois
authors.initials: F
authors.lastname: Guillemin
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Desandes
authors.forename: Frederic
authors.initials: F
authors.lastname: Marchal
mesh_terms: D000328:Adult; D000368:Aged; D002278:Carcinoma in Situ / Q000601:surgery*; D005260:Female; D006801:Humans; D053685:Laser Therapy / Q000379:methods*; D008875:Middle Aged; D012189:Retrospective Studies; D055502:Secondary Prevention; D013514:Surgical Procedures, Operative / Q000379:methods*; D016896:Treatment Outcome; D014846:Vulvar Neoplasms / Q000601:surgery*