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Federación Mexicana de Ginecología y Obstetricia, A.C.

2015, Number 10

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Ginecol Obstet Mex 2015; 83 (10)

Treatment results for different categories of vaginal intraepithelial neoplasia with electrocoagulation, 5-fluorouracil and combined treatment

Veloz-Martínez MG, Quintana-Romero V, Contreras-Morales MRS, Jiménez-Vieyra CR

Language: Spanish
References: 27
Page: 593-601
PDF size: 413.81 Kb.


ABSTRACT

Background: Vaginal intraepithelial neoplasia (VAIN) represents a variety of changes that initiate as an intraepithelial squamous lesion with the possibility of resulting in cancer.
Objective: To compare the results of the treatment for the different categories of VAIN with electrocoagulation, 5-fluorouracil and combined treatment.
Materials and methods: Observational an analytical study. We stablished groups according to the category of VAIN evaluating and comparing remission, persistence, recurrence, or progression of the disease according to the received treatment, with a 1-year follow up. The results were compared by χ2 and Kruskal Wallis. The statistics analysis was done with the SPSS program version 20.
Results: One hundred thirty seven patients between 20 and 81 years of age (mean age: 52.49 years) were included. Seventy-four percent of the patients had a history of premalignant or malignant cervical lesions. Seventy-four patients had VAIN I, 34 patients had VAIN II, 22 patients had VAIN III and there were seven cases of vaginal carcinoma in situ. Fifty-eight patients were treated with electrocoagulation, 55 patients were treated with 5-FU, 16 patients had combined treatment, and eight patients received expectant management. Sixty three percent of patients had total remission of the lesion, 34% had persistence and 3% showed progression, and there were no cases of recurrence. Results were better in patients with VAIN I treated with 5-FU (bigger percentage of remission P .026), for the remaining categories of VAIN, no treatment showed superior results.
Conclusions: The superior response occurs in patients with VAIN I treated with 5-FU. None of the treatments achieves a 100% remission. The VAIN frequency is high, patients with a history of malignant or premalignant cervical pathology should undergo a closer surveillance through cytocolposcopic control with respect to the remaining population.


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