Surgery or topical therapy for vulval intraepithelial neoplasia
Mené sur 180 patientes présentant une néoplasie intraépithéliale de la vulve de grade 3, cet essai multicentrique de phase II évalue l'efficacité, du point de vue de la réponse complète histologique 6 semaines après la fin du traitement, et les effets secondaires du cidofovir ou de l'imiquimod en application locale
The incidence of intraepithelial neoplasia of the vulva has been rising for the past few decades,1 possibly due to an increase of human papillomavirus (HPV)-associated high-grade squamous intraepithelial lesions, particularly in young women. High-grade squamous intraepithelial lesions (vulval intraepithelial neoplasia grade 2—3) are typically multifocal and judged to cause more than 90% of all diagnosed cases of vulval intraepithelial neoplasia. By contrast with low-grade squamous intraepithelial lesions (vulval intraepithelial neoplasia grade 1—2), which are usually self-limiting with a high rate of spontaneous regression, high-grade squamous intraepithelial lesions can progress to invasive carcinoma and are, therefore, defined as precancerous lesions. Untreated patients have a 6—9% risk of progression to vulval carcinoma ...
The Lancet Oncology , commentaire en libre accès, 2013