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Use of CO2 Laser Vaporization for the Treatment of High-Grade Vaginal Intraepithelial Neoplasia

Perrotta, Myriam MD; Marchitelli, Claudia E. MD; Velazco, Andrea F. MD; Tauscher, Patricia MD; Lopez, Graciela MD; Peremateu, Maria S. MD

Journal of Lower Genital Tract Disease: January 2013 - Volume 17 - Issue 1 - p 23–27
doi: 10.1097/LGT.0b013e318259a3ec
Original Articles

Objective: In a series of cases of high-grade vaginal intraepithelial neoplasia (VaIN) at our institution, to analyze its clinicopathologic characteristics, diagnostic methodology, and therapeutic results obtained with the use of CO2 laser vaporization.

Materials and Methods: Between January 2003 and December 2009, 28 patients with a diagnosis of high-grade VaIN were treated in our department using CO2 laser vaporization. Of the 28 patients, 7 were lost to follow-up; 21 patients were followed up with cytological examination and colposcopy for therapeutic response. Median follow-up was 25 months (range = 12–78 months). The setting is an urban referral center, a private hospital with a high-grade complexity.

Results: Of the 21 patients evaluated, 18 are currently disease free after having undergone a single application of CO2 laser vaporization with a cure rate of 86% (95% CI = 63.7%–97%). Three patients (14%) presented with persistence/recurrence and required a second application. Of these 3 patients, 2 are currently disease free, whereas 1 patient progressed to invasive carcinoma 11 months after a second procedure and was managed with partial colpectomy and pelvic lymphadenectomy.

Conclusions: CO2 laser vaporization was effective for the initial treatment of high-grade VaIN. However, a long-term follow-up is required due to the recurrent character of this disease.

CO2 laser vaporization was effective in the initial treatment of high-grade VaIN, in 21 patients, with a cure rate of 86%.

Department of Gynecology, Hospital Italiano of Buenos Aires, Buenos Aires, Argentina

Reprint requests to: Maria S. Peremateu, MD, 3 De Febrero 3643 Floor 3° Apt “A” CP (1429) Ciudad Autonoma De Buenos Aires, Buenos Aires, Argentina. E-mail: maria.peremateu@hospitalitaliano.org.ar

The authors have no financial and conflict of interest to disclose.

©2013The American Society for Colposcopy and Cervical Pathology