ArticleActa obstetricia et gynecologica Scandinavica2024
Differentiated vulvar intraepithelial neoplasia long-term follow up and prognostic factors: An analysis of a large historical cohort.
Article in Acta obstetricia et gynecologica Scandinavica, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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Who cites it
15 citing papers in PubMed, 18 citations in OpenAlex.
- Vulvar Squamous Cell Carcinoma: Scientific Progress and Impacts to Pathology Practice.International journal of gynecological pathology : official journal of the International Society of Gynecological Pathologists · 2026Review
- Development of a risk assessment model for the recurrence of high-grade squamous intraepithelial lesions and differentiated vulvar intraepithelial neoplasia in Chinese cohort.Discover oncology · 2026Article
- A Rare Presentation of Vulvar Discoid Lupus Erythematosus Masquerading as Lichen Sclerosus.Case reports in obstetrics and gynecology · 2026Article
- Vulvar Squamous Cell Carcinoma: A Retrospective Analysis of Epidemiologic Characteristics, HPV Status, and Surgical Outcomes in 35 Cases.Life (Basel, Switzerland) · 2025Article
- Exploring Genital Lichen Sclerosus: Navigating from Pathophysiology to Precise Diagnostic Approaches.Biomedicines · 2025Review
- Platelet-Rich Plasma Versus Saline for the Treatment of Vulvar Lichen Sclerosus: Protocol for a Randomized Controlled Trial.JMIR research protocols · 2025Article
- The future of research on vulvar intraepithelial neoplasia: towards precision diagnostics and risk stratification.Journal of the Turkish German Gynecological Association · 2025Article
- ROS1 Expression Correlates With Inguinal Lymph Node Affection in Vulvar Cancer Patients: A Retrospective Study.Cancer medicine · 2025Article
- Reconstruction of the Vulva and Perineum-Comparison of Surgical Methods.Journal of clinical medicine · 2025Review
- Non-invasive diagnosis of vulvar dysplasia using cervical methylation markers-a case control study.BMC medicine · 2025Article
- Case Report: Diagnostic challenges in differentiated-type vulvar intraepithelial neoplasia.Frontiers in oncology · 2025Article
- Molecular Subtypes of Vulvar Squamous Cell Carcinoma: The Significance of HPV-Independent/p53 Wild Type.Cancers · 2024Review
- Squamous Cell Carcinoma In Situ-The Importance of Early Diagnosis in Bowen Disease, Vulvar Intraepithelial Neoplasia, Penile Intraepithelial Neoplasia, and Erythroplasia of Queyrat.Diagnostics (Basel, Switzerland) · 2024Review
- Differentiated vulvar intraepithelial neoplasia long-term follow up and prognostic factors: An analysis of a large historical cohort.Acta obstetricia et gynecologica Scandinavica · 2024Article
- Review
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Authors and funding
14 authors at 6 institutions in 4 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionDifferentiated vulvar intraepithelial neoplasia (dVIN) is a high-risk preinvasive vulvar lesion and precursor of human papillomavirus-independent vulvar squamous cell carcinoma (VSCC). Due to its rarity, literature data on its malignant potential are scant. The aim of the study is to assess the risk of developing VSCC in patients surgically treated for dVIN not associated with VSCC (solitary dVIN) and the risk of VSCC recurrence in patients treated for dVIN associated with VSCC (dVIN-VSCC) at first diagnosis. MATERIAL AND
methodsA historical cohort study was performed in a northern Italy referral center for vulvar neoplasms. All consecutive women surgically treated for histologically confirmed dVIN from 1994 to 2021 were collected. Primary outcome was cancer risk or recurrent cancer risk, secondary outcomes were risk factors associated with VSCC development or recurrence. Kaplan-Meier method and log-rank test were used to estimate cancer risk or recurrent cancer risk differences and uni- and multivariate Cox regression analyses to identify risk factors associated with VSCC development in solitary dVIN and recurrence of dVIN-VSCC.
resultsSeventy-six patients with dVIN at preoperative biopsy were included: at excisional specimens 44 were solitary dVIN and 32 were dVIN-VSCC. The absolute risk of VSCC development after solitary dVIN treatment was 43.2% with median time to to VSCC diagnosis of 25.4 months (range 3.5-128.0 months). VSCC recurrence absolute risk in treated dVIN-VSCC patients was 31.3% with median time to VSCC recurrence of 52.9 months (range 6.5-94.8 months). At uni- and multivariate regression analyses, only compliant topical ultrapotent corticosteroid treatment after solitary dVIN excision showed an ability to prevent VSCC development. No protective effect by corticosteroid treatment was shown for VSCC recurrence in dVIN-VSCC patients. Smoking was associated with higher cancer recurrence risk in dVIN-VSCC patients on both uni- and multivariate regression analyses.
conclusionsPatients with dVIN have a high risk of developing both primary and recurring VSCC. Early recognition, long-term follow up, and compliant ultrapotent topical corticosteroid treatment are recommended.
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