Adjuvant topical treatment with imiquimod 5% after excisional surgery for VIN 2/3

OBJECTIVE : Vulvar intraepithelial neoplasia (VIN) is a premalignant lesion of the vulva. The incidence of VIN is increasing. The surgery is currently the gold standard therapy for VIN, but Imiquimod could be a completion to surgery. The aim of this study is to compare the overall complete response, the recurrence rate and the risk factors for recurrence among two groups of patients: women with high grade VIN underwent surgery and patients treated with surgery plus Imiquimod. PATIENTS AND METHODS: 80 patients with histologically diagnosedVIN 2/3 were enrolled in this prospective study. Our patients were divided into two groups: 40 women underwent surgery (A) and 40 patients were treated with surgery plus Imiquimod (B). All women had a 5-year fol - low-up. Recurrence rate and complete response were evaluated. The following patients' charac - teristics were analyzed: smoke, multifocal dis - ease, multicentric disease, degree of the lesion. RESULTS: In the group A recurrence rate was 44.8%, in the group B it was 48.4%. In both groups the presence of multifocal lesions ( p = 0.02) and VIN 3 ( p = 0.006) before treatment was associated with a higher risk of recurrence. CONCLUSIONS: This study found that surgery remains the principal approach for VIN with re - gard to relapse and complete response since the treatment with Imiquimod associated with surgery didn't show a lower recurrence rate. Al - though the surgical treatments remain the best therapeutic option for VIN with regard to recur - rence and overall complete response, the com - bined therapy seems to be an interesting modali - ty, but further studies are needed .