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Therapeutic effect of laser vaporization for vaginal intraepithelial neoplasia following hysterectomy due to premalignant and malignant lesions
Author(s) -
Wang Yan,
Kong WeiMin,
Wu YuMei,
Wang JianDong,
Zhang WeiYuan
Publication year - 2014
Publication title -
journal of obstetrics and gynaecology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 50
eISSN - 1447-0756
pISSN - 1341-8076
DOI - 10.1111/jog.12383
Subject(s) - medicine , cervical intraepithelial neoplasia , odds ratio , hysterectomy , confidence interval , cervical cancer , persistence (discontinuity) , intraepithelial neoplasia , laser surgery , urology , surgery , cancer , gynecology , laser , prostate , geotechnical engineering , engineering , physics , optics
Aim The aim of this study was to evaluate the therapeutic effect of laser vaporization for vaginal intraepithelial neoplasia ( VAIN ) after hysterectomy in C hinese women and to identify factors affecting persistence/recurrence. Material and Methods Twenty‐eight VAIN patients after hysterectomy due to cervical intraepithelial neoplasia (group 1) and 11 VAIN patients due to cervical cancer (group 2) were reviewed retrospectively. All patients were treated with at least one episode of laser vaporization between 2010 and 2011, and then followed up every 3 months for at least 1 year. Cox regression analysis was used to identify independent factors predicting persistence/recurrence. Results All VAIN patients achieved remission after two episodes of laser treatment, with 85.7% complete regression in group 1 and 54.5% in group 2. The first episode of the treatment had a significantly higher success rate in group 1 than in group 2 (46.2% vs 0.0%). All patients had no recurrence during a mean follow‐up time of 22.8–27.8 months (range 12–39 months). However, infection persisted in 21 (61.8%) of 34 human‐papillomavirus‐positive patients after laser vaporization. Severity of VAIN was the only significant independent predictor of persistence/recurrence after one episode of the treatment (adjusted odds ratio, 4.08; 95% confidence interval, 1.28–12.96; P = 0.017). Laser treatments were well tolerated with no major side‐effects. Conclusion Laser vaporization may be a useful option for the treatment of VAIN after hysterectomy. However, a follow‐up is required to assess the long‐term efficacy of laser treatment.