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Treatment of vulvar intraepithelial neoplasia with topical 5% imiquimod cream
Author(s) -
Westermann Claudia,
Fischer Anna,
Clad Andreas
Publication year - 2013
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1016/j.ijgo.2012.09.020
Subject(s) - medicine , imiquimod , vulvar intraepithelial neoplasia , lesion , biopsy , dermatology , adverse effect , vulva , complete response , grading (engineering) , dose , surgery , gastroenterology , chemotherapy , civil engineering , engineering
Objective To assess the efficacy of 5% imiquimod cream for treating vulvar intraepithelial neoplasia (VIN). Methods In a retrospective study, data were analyzed from 62 patients with biopsy‐diagnosed VIN stage I–III who were treated with 5% imiquimod cream at University Hospital of Freiburg, Germany, between 2004 and 2011. Several patient and lesion characteristics were evaluated, and follow‐up was 3–72 months (median 21 months). Results Among 62 women treated, 47 (76%) showed a complete response, 12 (19%) showed a partial response, 2 (3%) showed a weak partial response, and 1 did not respond. Disease recurrence occurred for 17 (27%) women. Recurrence rates were significantly lower among HPV‐positive patients ( P = 0.046), and among women younger than 65 years ( P = 0.030). Patients without local inflammation during treatment were less likely to show a complete response ( P = 0.049). Response rates did not depend on lesion size; however, women with large lesions required longer treatment and higher total dosages for a complete response. Conclusion 5% imiquimod cream was found to be a favorable alternative to ablative treatment of VIN independently of lesion grading, appearance, and size. Patient age, HPV status, and occurrence of adverse effects significantly influenced treatment outcome.