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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