Prognosis in Vulvar Intraepithelial Neoplasia (VIN): Recurrence Frequency and Vulva Cancer Development Process

Prognosis in Vulvar Intraepithelial Neoplasia (VIN): Recurrence Frequency and Vulva Cancer Development Process

VIN is detected, they told you to have operation and you said “No, hell with the world”, what happens? 🙂

Prognosis In Vulvar Intraepithelial Neoplasia (VIN): Vulva Cancer Development and Recurrence Frequency

The most important study by far regarding the assessment of the prognosis of VIN is the research published by van Seters et al. in 2005 in Gyn. Oncology. In this study the published studies were evaluated and total of 3322 cases were examined (van Seters M., van Beurden M., de Craen A.J. Is the assumed natural history of vulvar intraepithelial neoplasia III based on enough evidence? A systematic review of 3322 published patients. Gynecol Oncol. 2005;97: 645).

). If you may read the section about their classification in the part related to VIN, I would be glad. You know that we are examining the VIN in 2 main groups: 1. HPV related ordinary VIN (Undifferentiated) and Differentiated VIN. HPV related VIN is seen frequently in young women.

Their frequency of developing a cancer changes between 4 to 6%. Vulva cancer development is indicated as 4 years in this publication.

However, in non HPV related differentiated VIN cases that have lesions like lichen simplex at the base and seen frequently in older women in menopause, frequency of developing to a cancer is around 33% and tumor develops faster.

It is shown that VIN 3 cases develop invasive vulva cancer in a ratio of 6.5%. Thus their follow up is very important.

Relapse Probability in VIN

Vulvar epithelial neoplasia (VIN) is a disease with high rate of relapse regardless of the treatment applied. 1 in every 3 VIN case relapse is seen. However some conditions increase the relapse frequency.

Relapse of the illness after treatment depends on several factors:

  1. The most important factor in relapse of the illness is whether the margins are positive or negative, i.e. surgery.
  2. Lesion being on several foci
  3. Smoking
  4. Usage of immunosuppressor drugs
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