title: High-grade vaginal intraepithelial neoplasia and risk of progression to vaginal cancer: a multicentre study of the Italian Society of Colposcopy and Cervico-Vaginal Pathology (SICPCV).
abstract: OBJECTIVE
  The aim of this study was to analyse the women with high grade vaginal intraepithelial neoplasia (HG-VaIN), in order to identify a subset of women at higher risk of progression to invasive vaginal cancer.
  
  
  METHODS
  The medical records of all the women diagnosed with HG-VaIN, and subsequently treated, from January 1995 to December 2013 were analyzed in a multicentre retrospective case series. The rate of progression to invasive vaginal cancer and the potential risk factors were evaluated.
  
  
  RESULTS
  205 women with biopsy diagnosis of HG-VaIN were considered, with a mean follow up of 57 months (range 4-254 months). 12 cases of progression to vaginal squamocellular cancer were observed (5.8%), with a mean time interval from treatment to progression of 54.6 months (range 4-146 months). The rate of progression was significantly higher in women diagnosed with VaIN3 compared with VaIN2 (15.4% vs. 1.4%, p < 0.0001). Women with HG-VaIN and with previous hysterectomy showed a significantly higher rate of progression to invasive vaginal cancer compared to non-hysterectomised women (16.7% vs. 1.4%, p < 0.0001). A higher risk of progression for women with VaIN3 and for women with previous hysterectomy for cervical HPV-related disease was confirmed by multivariable logistic regression analysis.
  
  
  CONCLUSIONS
  A higher rate of progression to vaginal cancer was reported in women diagnosed with VaIN3 on biopsy and in women with previous hysterectomy for HPV-related cervical disease. These patients should be considered at higher risk, thus a long lasting and accurate follow up is recommended.
authors.affiliation: Gynecological Oncology Unit, Centro di Riferimento Oncologico - National Cancer Institute, Aviano, Italy. ciavattini.a@libero.it.
authors.forename: F
authors.initials: F
authors.lastname: Sopracordevole
authors.forename: M
authors.initials: M
authors.lastname: Barbero
authors.forename: N
authors.initials: N
authors.lastname: Clemente
authors.forename: M G
authors.initials: MG
authors.lastname: Fallani
authors.forename: P
authors.initials: P
authors.lastname: Cattani
authors.forename: A
authors.initials: A
authors.lastname: Agarossi
authors.forename: G
authors.initials: G
authors.lastname: De Piero
authors.forename: A
authors.initials: A
authors.lastname: Parin
authors.forename: A
authors.initials: A
authors.lastname: Frega
authors.forename: F
authors.initials: F
authors.lastname: Boselli
authors.forename: F
authors.initials: F
authors.lastname: Mancioli
authors.forename: M
authors.initials: M
authors.lastname: Buttignol
authors.forename: F
authors.initials: F
authors.lastname: Currado
authors.forename: A
authors.initials: A
authors.lastname: Pieralli
authors.forename: A
authors.initials: A
authors.lastname: Ciavattini
mesh_terms: D000328:Adult; D000368:Aged; D002278:Carcinoma in Situ / Q000175:diagnosis* / Q000453:epidemiology* / Q000473:pathology; D003127:Colposcopy / Q000379:methods; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008875:Middle Aged; D060787:Neoplasm Grading; D011247:Pregnancy; D012189:Retrospective Studies; D012307:Risk Factors; D014625:Vaginal Neoplasms / Q000175:diagnosis* / Q000453:epidemiology*