Epidemiology and evaluation of the importance of surgical margins in the treatment of vulvar H-SIL, analysis of own data.

Abstract

Objective: Epidemiology and evaluation of the importace of surgical margins in treatment of vulvar H-SIL – analysis of own data.

Methods: The prospective study included women diagnosed with HPV associated vulvar epithelial neoplasia from 10/2016 to 1/2022. Generally 65 women were included. After surgical treatment the women were distributed to groups according to surgical margins and were followed-up in regullar check-ups.  

Results: 17 (26%) women diagnosed with HPV associated vulvar intraepithelial neoplasia were under 49 years, whereas 48 (74%) women were older than 49 years. Recurrence rates of HPV associated vulvar epithelial neoplasia after surgical treatment were 12.3, 1.5 and 3.1% in excisions with positive margins, up to 1mm peripheral margins and 1-3mm peripheral margins respectively. The risk of recurrence in positive margins versus peripheral margins (1-3mm) is statistically significant.

Conclusion: Keeping the minimal negative margin (1-3mm) seems acceptable risk of recurrence of HPV associated vulvar intraepithelial neoplasia with positive cosmetic effect and minimal risk of disturbing the psychosexual function in women. Long-lasting follow-up is necessary.