{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,14]],"date-time":"2026-02-14T06:09:29Z","timestamp":1771049369261,"version":"3.50.1"},"reference-count":25,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["J Low Genit Tract Dis"],"published-print":{"date-parts":[[2023,4]]},"abstract":"<jats:sec>\n            <jats:title>Objective<\/jats:title>\n            <jats:p>This study aimed to analyze which clinical characteristics are associated with recurrence and progression of vulvar high-grade squamous intraepithelial lesion (vHSIL).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Materials and Methods<\/jats:title>\n            <jats:p>This was a retrospective cohort study, including all women with vHSIL followed in 1 center between 2009 and 2021. Women with a concomitant diagnosis of invasive vulvar cancer were excluded. Medical records were reviewed for demographic factors, clinical data, treatment type, histopathologic results, and follow-up information.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>A total of 30 women were diagnosed with vHSIL. The median follow-up time was 4 years (range = 1\u201312 years). More than half of the women (56.7% [17\/30]) underwent excisional treatment, whereas 26.7% (8\/30) underwent combined (excisional plus medical) treatment, and 16.7% (5\/30) only had medical treatment (imiquimod). Six women had recurrence of vHSIL (20% [6\/30]), with a mean time to recurrence of 4.7 \u00b1 2.88 years. The progression rate to invasive vulvar cancer was 13.3% (4\/30), with a mean time to progression of 1.8 \u00b1 0.96 years. Multifocal disease was associated with progression to vulvar cancer (<jats:italic toggle=\"yes\">p<\/jats:italic> = .035). We did not identify other variables associated with progression; no differences were found between women with and without recurrences.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>Multifocality of the lesions was the only variable associated with progression to vulvar cancer. This reinforces the idea that these lesions are a challenge in both treatment and surveillance, involving a more difficult therapeutic decision with greater associated morbidity.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/lgt.0000000000000726","type":"journal-article","created":{"date-parts":[[2023,2,16]],"date-time":"2023-02-16T12:00:28Z","timestamp":1676548828000},"page":"125-130","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":9,"title":["Vulvar High-Grade Squamous Intraepithelial Lesion and the Risk of Recurrence and Progression to Cancer"],"prefix":"10.1097","volume":"27","author":[{"given":"Joana","family":"Xavier","sequence":"first","affiliation":[{"name":"Department of Gynaecology, Centro Hospitalar Universit\u00e1rio S\u00e3o Jo\u00e3o, Porto, Portugal"}]},{"given":"Rita","family":"Figueiredo","sequence":"additional","affiliation":[{"name":"Department of Gynaecology, Centro Hospitalar Universit\u00e1rio S\u00e3o Jo\u00e3o, Porto, Portugal"}]},{"given":"Pedro","family":"Vieira-Baptista","sequence":"additional","affiliation":[]}],"member":"276","published-online":{"date-parts":[[2023,2,16]]},"reference":[{"key":"bib1-20250524","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1097\/LGT.0000000000000169","article-title":"The 2015 International Society for the Study of Vulvovaginal Disease (ISSVD) Terminology of Vulvar Squamous Intraepithelial Lesions","volume":"20","year":"2016","journal-title":"J Low Genit Tract Dis"},{"key":"bib2-20250524","doi-asserted-by":"crossref","first-page":"1051","DOI":"10.1016\/j.bpobgyn.2014.07.010","article-title":"Vulvar intraepithelial neoplasia","volume":"28","year":"2014","journal-title":"Best Pract Res Clin Obstet Gynaecol"},{"key":"bib3-20250524","first-page":"229","article-title":"The European Society of Gynaecological Oncology (ESGO), the International Society for the Study of Vulvovaginal Disease (ISSVD), the European College for the Study of 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