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VIN 3: a clinicopathologic review.

O M McNally1, N J Mulvany, R Pagano

  • 1Department of Gynaecology/Oncology, Aberdeen Royal Infirmary, Foresterhill, Scotland.

International Journal of Gynecological Cancer : Official Journal of the International Gynecological Cancer Society
|October 9, 2002
PubMed
Summary
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Vulvar intraepithelial neoplasia 3 (VIN 3) management involved wide local excision for most patients. Recurrence was common, but VIN 3 rarely progressed to invasive vulvar cancer.

Area of Science:

  • Gynecologic Oncology
  • Dermatopathology
  • Surgical Pathology

Background:

  • Vulvar intraepithelial neoplasia 3 (VIN 3) is a premalignant condition of the vulva.
  • Management strategies and outcomes for VIN 3 require ongoing evaluation.

Purpose of the Study:

  • To review the management and outcomes of VIN 3 over a 16-year period.
  • To identify factors influencing recurrence and progression of VIN 3.

Main Methods:

  • Retrospective review of 101 patients diagnosed with VIN 3 between 1981 and 1997.
  • Analysis of patient demographics, clinical presentation, treatment modalities, and follow-up data.
  • Evaluation of recurrence rates and progression to invasive squamous cell carcinoma.

Main Results:

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  • Wide local excision was the primary treatment for 78% of patients.
  • Thirty-eight percent of patients experienced recurrent disease.
  • Human papillomavirus (HPV) infection was present in 31% of cases.
  • Progression to invasive vulvar cancer occurred in 3% of patients.

Conclusions:

  • Wide local excision is a common treatment for VIN 3, but recurrence is frequent.
  • Smoking, multifocality, HPV, and positive margins were not significant predictors of recurrence in this cohort.
  • VIN 3 has a low but significant risk of progression to invasive squamous cell carcinoma.