Natural History of Primary Vaginal Intraepithelial Neoplasia With and Without Treatment: A Systematic Review and Meta-Analysis—Graphical Abstract

This study was conducted by a multidisciplinary Italian research team led by Dr. Ugo Indraccolo, with contributions from Chiara Borghi, Marta Mattei Gentili, Gennaro Scutiero, Emanuele Caselli, and Alessandro Favilli, bringing together clinicians and researchers from major hospitals and academic centers across Umbria, Piedmont, South Tyrol, and the University of Perugia.

It was published in Clinical and Experimental Obstetrics & Gynecology (CEOG), Volume 52, Issue 8.

Authors’ Summary

This is a systematic review and descriptive meta-analysis. We searched PubMed, Scopus, WoS, and SciELO databases for articles to collect clinical series reporting information on no-regression rate (persistence, recurrence, or progression events) of primary VaIN. We recorded data categorizing by VaIN grade and treatment status. Clinical series that reported VaIN grade, follow-up time (median/mean of six months or more), treatment details, and whether treatment was performed were eligible for assessment.

Data syntheses were pooled at each follow-up time point by setting a time interval of six months. From these pooled rates, trend shapes were constructed to describe the natural history of treated (various treatments) and untreated low-grade and high-grade VaINs.

Results. One hundred and fifty series were included in the data syntheses. Five sub-groups were assessed for low-grade VaINs, and twelve for high-grade VaINs. The estimated 5-year no-regression rate of untreated low-grade VaINs, predicted by trend shape, was 14.0% (95% CI 9.2%–44.0%), meaning that 86.0% of untreated low-grade VaINs would heal in 5-years. The 5-year no-regression rate for untreated high-grade VaINs, also predicted by trend shape, was 14.2% (95% CI 10.2%–24.8%), meaning that 85.8% of untreated high-grade VaINs would heal in 5-years.

It can not be ascertained to what extent treatments modify the natural history of VaINs. Assessments suggest that a substantial amount of low-level evidence is currently available on VaINs. Therefore, the large amount of untreated VaIN lesions, regardless of grade, would heal after a 5 years follow-up and at least 14% of VaIN lesions are unlikely to resolve.

Read the article:

Natural History of Primary Vaginal Intraepithelial Neoplasia With and Without Treatment: A Systematic Review and Meta-Analysis: https://www.imrpress.com/journal/CEOG/52/8/10.31083/CEOG36377

Vaginal Intraepithelial Neoplasia and Efficacy of Its Treatments: A Simulation: https://www.imrpress.com/journal/CEOG/52/10/10.31083/CEOG42078

Correlation between Indicators of Vaginal Microbiota and Human Papillomavirus Infection: A Retrospective Study: https://www.imrpress.com/journal/CEOG/51/4/10.31083/j.ceog5104094