Epidemiology and significance of surgical margins in the management of HPV-associated vulvar precancers (H-SIL) – analysis of own data

Abstract

Objective: Epidemiology and evaluation of the importance of surgical margins in the treatment of vulvar H-SIL – analysis of own data. Material and methods: The prospective study included women diagnosed with HPV-associated vulvar epithelial neoplasia from 10/2016 to 1/2022. A total of 65 women were included. After surgical treatment, the women were distributed to groups according to surgical margins and were followed-up at regular intervals. Results: Seventeen women (26%) diagnosed with HPV-associated vulvar intraepithelial neoplasia were under 49 years, whereas 48 women (74%) were older than 49 years. Recurrence rates of HPV-associated precancers were 12.3%, 1.5% and 3.1% in excisions with positive margins up to 1 mm peripheral margins and 1–3 mm peripheral margins, respectively. The risk of recurrence when the lesion reaches the margin is statistically significant, compared to a healthy margin of 1–3 mm. Conclusion: Keeping the minimal healthy margin (1–3 mm) seems to be an acceptable risk of recurrence of HPV-associated vulvar intraepithelial neoplasia with positive cosmetic effect and minimal risk of disturbing the psychosexual functions of women. Long-term regular follow-up is necessary. Key words: vulvar intraepithelial neoplasia – H-SIL – surgical margins – epidemiology