IMPACT OF HISTOLOGICAL TUMOR-FREE MARGIN (hTFM) AND RE-EXCISION ON SURVIVAL IN PRIMARY VULVAR CANCER WITH ADJACENT VULVAR INTRAEPITHELIAL NEOPLASIA (VIN III)

The aim of this review was an update of vulvar cancer incidence rates and trends and of all known and putative risk factors for the disease. The most recent incidence data were sought from official sources (WHO Cancer Incidence in Five Continents). To obtain an estimate of time trends in some areas, we compared data from Cancer Incidence in Five Continents with the few available studies that measured incidence using comparable methods. With respect to risk factors, a systematic PubMed search identified 1585 relevant articles published between 1980 and 2021. Abstracts and full texts were screened. Sixty-nine eligible original cohort and case-control studies were selected. Information was extracted using a PRISMA predesigned form. Nineteen risk factors, or risk factor categories, were investigated by two or more original studies. Solitary, unreplicated studies addressed the putative role of eight more factors. Recent advances have provided further evidence supporting the carcinogenic model centred on human papillomavirus infection with different defects of the immune function. Conversely, the model centred on the role of vulvar lichen sclerosus and the often associated differentiated vulvar intraepithelial neoplasia has continued to be epidemiologically understudied. More research on the association between these two conditions and vulvar cancer is a priority.

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Faculty Opinions recommendation of Progression of simplex (differentiated) vulvar intraepithelial neoplasia to invasive squamous cell carcinoma: a prospective case study confirming its precursor role in the pathogenesis of vulvar cancer.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.1089645.544915 ◽

2007 ◽

Author(s):

Dmitry Kazakov

Keyword(s):

Squamous Cell Carcinoma ◽

Cell Carcinoma ◽

Squamous Cell ◽

Vulvar Cancer ◽

Intraepithelial Neoplasia ◽

Vulvar Intraepithelial Neoplasia ◽

Invasive Squamous Cell Carcinoma

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Serum Concentrations of Tissue Polypeptide Antigen in Patients with Vulvar Intraepithelial Neoplasia and Vulvar Cancer

Tumor Biology ◽

10.1159/000030115 ◽

2000 ◽

Vol 21 (2) ◽

pp. 98-104 ◽

Cited By ~ 2

Author(s):

Lukas Hefler ◽

Clemens Tempfer ◽

Katrin Frischmuth ◽

Georg Maenner ◽

Nicole Concin ◽

...

Keyword(s):

Vulvar Cancer ◽

Intraepithelial Neoplasia ◽

Vulvar Intraepithelial Neoplasia ◽

Serum Concentrations ◽

Tissue Polypeptide Antigen

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The role of angiogenesis in vulvar cancer, vulvar intraepithelial neoplasia, and vulvar lichen sclerosus as determined by microvessel density analysis

Gynecologic Oncology ◽

10.1016/s0090-8258(03)00055-6 ◽

2003 ◽

Vol 89 (2) ◽

pp. 251-258 ◽

Cited By ~ 12

Author(s):

Jamna Saravanamuthu ◽

Wendy M.N Reid ◽

David S.t George ◽

Julie C Crow ◽

Kerstin J Rolfe ◽

...

Keyword(s):

Microvessel Density ◽

Vulvar Cancer ◽

Lichen Sclerosus ◽

Intraepithelial Neoplasia ◽

Vulvar Intraepithelial Neoplasia ◽

Density Analysis ◽

Vulvar Lichen Sclerosus

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Vulvar intraepithelial neoplasia. Literature review

Tumors of female reproductive system ◽

10.17650/1994-4098-2021-17-3-114-120 ◽

2021 ◽

Vol 17 (3) ◽

pp. 114-120

Author(s):

V. S. Levchenko ◽

E. V. Grebenkina ◽

N. A. Illarionova ◽

E. N. Koroleva ◽

S. V. Zinovyev ◽

...

Keyword(s):

Older Women ◽

White Women ◽

Vulvar Cancer ◽

Treatment Options ◽

Lichen Sclerosus ◽

Intraepithelial Neoplasia ◽

Vulvar Intraepithelial Neoplasia ◽

Basal Cells ◽

Screening Programs ◽

Long Time

Vulvar intraepithelial neoplasia (VIN) is the proliferation of atypical basal cells in the vulvar epithelium. The global VIN incidence has recently doubled; its incidence among white women under 35 years of age has almost tripled with a tendency for further growth. Such an increase in the number of usual-type VIN cases in young women is primarily attributed to infection with highly oncogenic human papillomavirus. The second type of dysplasia, namely differentiated VIN, is usually found in older women and is associated with chronic dystrophic diseases of the vulva, most frequently with lichen sclerosus of the vulva. VIN diagnosis is quite challenging; no screening programs for this disorder have been developed so far. Patients with VIN practice self-treatment for a long time, which aggravates their condition and might trigger the development of vulvar cancer. Several treatment options are currently available; however, their efficacy worldwide is not high.

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Patients with usual vulvar intraepithelial neoplasia-related vulvar cancer have an increased risk of cervical abnormalities

British Journal of Cancer ◽

10.1038/sj.bjc.6605124 ◽

2009 ◽

Vol 101 (1) ◽

pp. 27-31 ◽

Cited By ~ 21

Author(s):

R P de Bie ◽

H P van de Nieuwenhof ◽

R L M Bekkers ◽

W J G Melchers ◽

A G Siebers ◽

...

Keyword(s):

Vulvar Cancer ◽

Intraepithelial Neoplasia ◽

Vulvar Intraepithelial Neoplasia ◽

Increased Risk

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The main differences between vulvar intraepithelial neoplasia and vulvar intraepithelial lesion

Obstetrics & Gynecology International Journal ◽

10.15406/ogij.2020.11.00531 ◽

2020 ◽

Vol 11 (5) ◽

Author(s):

Vivian de Oliveira Rodrigues Brum ◽

Denise Gasparetti Drumond ◽

Neila Maria de Góis Speck ◽

Gabriel Duque Pannain ◽

Giovana Moreira Bordim

Keyword(s):

Vulvar Cancer ◽

Gynecological Cancer ◽

Squamous Carcinoma ◽

Intraepithelial Neoplasia ◽

Final Diagnosis ◽

Hpv Infection ◽

Vulvar Intraepithelial Neoplasia ◽

Low Grade ◽

Intraepithelial Lesion ◽

The Difference

Vulvar cancer is a recurrent subject in gynecological cancer. Vulvar Intraepithelial Neoplasia is known for being a precursor lesion of vulvar cancer and can be divided in three different subtypes: Low-grade Vulvar Intraepithelial Lesion (vulvar LSI), High-grade Vulvar Intraepithelial Lesion (vulvar HSIL) and Differentiated Vulvar Intraepithelial Neoplasia (dVIN). These subtypes differ in several aspects, and this article aims to present those differences in order to facilitate its treatment and the final diagnosis. The HSIL is the most associated with cronic Human Papilloma Virus (HPV) infection and can be related to other environment factors. As for dVIN, it’s more frequent in post-menopausal women with sclerosis lichen and it has a higher rate of progression to vulvar squamous carcinoma. The difference must be made in order to choose what is the best treatment, once there are various modalities, such as simple excision, CO2 ablation and topical application of imiquimod or fluoracil. This differences is also important for the development of measures that seek specific prevention, such as HPV vaccine for the HSIL and the proper treatment of vulvar conditions for the dVIN.

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