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

Authors: T. Pichlík 1,2 ;  L. Rob 1 ;  M. J. Halaška 1 ;  J. Drozenová 3;  H. Robová 1
Authors‘ workplace: Gynekologicko-porodnická klinika 3. LF UK a FNKV, Praha 1;  Lékařská fakulta, UK v Plzni 2;  Ústav patologie 3. LF UK a FNKV, Praha 3
Published in: Ceska Gynekol 2022; 87(6): 384-387
Category: Original Article
doi: 10.48095/cccg2022384


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.


Epidemiology – vulvar intraepithelial neoplasia – H-SIL – surgical margins


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Paediatric gynaecology Gynaecology and obstetrics Reproduction medicine
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