{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T11:16:53Z","timestamp":1785842213414,"version":"3.56.0"},"reference-count":26,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2013,4,2]],"date-time":"2013-04-02T00:00:00Z","timestamp":1364860800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2013,6]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To determine the role of conservative management in high\u2010grade vaginal intraepithelial neoplasia (<jats:styled-content style=\"fixed-case\">HG V<\/jats:styled-content>a<jats:styled-content style=\"fixed-case\">IN<\/jats:styled-content>).<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Retrospective observational study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Northern <jats:styled-content style=\"fixed-case\">G<\/jats:styled-content>ynaecological <jats:styled-content style=\"fixed-case\">O<\/jats:styled-content>ncology <jats:styled-content style=\"fixed-case\">C<\/jats:styled-content>entre, <jats:styled-content style=\"fixed-case\">G<\/jats:styled-content>ateshead, <jats:styled-content style=\"fixed-case\">UK<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Population<\/jats:title><jats:p>A total of 100 women with histologically\u2010proven <jats:styled-content style=\"fixed-case\">HG V<\/jats:styled-content>a<jats:styled-content style=\"fixed-case\">IN<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Review of patient records from 1995 to 2011.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcome measures<\/jats:title><jats:p>Rates of progression to cancer, treatment remission, and disease recurrence, particularly post\u2010treatment when vaginoscopy is normal but cytology is abnormal.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 100 women referred, 69 underwent initial treatment of whom 47 (68%) went into remission: of these, seven developed a recurrence after a median follow\u2010up of 29\u00a0months (range 15\u2013214\u00a0months). Of the 31 women managed conservatively with cytological and vaginoscopic surveillance, no cancers developed after a median follow\u2010up of 35\u00a0months (range 2\u2013230\u00a0months). Rate of overall progression to cancer was 3% and all were detected among the initial treatment group after a median of 59\u00a0months (range 8\u2013249\u00a0months). Post\u2010treatment, when normal vaginoscopy was accompanied by abnormal cytology, two categories existed. Of 24 cases with low\u2010grade cytological abnormality, recurrence of <jats:styled-content style=\"fixed-case\">HG<\/jats:styled-content> Va<jats:styled-content style=\"fixed-case\">IN<\/jats:styled-content> occurred in seven (29%) after a median follow\u2010up of 12\u00a0months (range 2\u2013110\u00a0months). Of 19 cases with <jats:styled-content style=\"fixed-case\">HG<\/jats:styled-content> cytological abnormality, 15 (79%) developed recurrence at a median follow\u2010up of 7\u00a0months (range 2\u201321\u00a0months), giving a hazard ratio 5.6 (95% confidence interval 2.0\u201315.5, <jats:italic>P\u00a0<\/jats:italic>=\u00a00.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>It is possible to select women with <jats:styled-content style=\"fixed-case\">HG V<\/jats:styled-content>a<jats:styled-content style=\"fixed-case\">IN<\/jats:styled-content> for conservative surveillance with excellent results. The majority of women undergoing initial treatment will enter remission. Post\u2010treatment, if cytological abnormality develops in the presence of normal vaginoscopy, the majority of women will develop histological <jats:styled-content style=\"fixed-case\">HG V<\/jats:styled-content>a<jats:styled-content style=\"fixed-case\">IN<\/jats:styled-content> recurrence.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1471-0528.12223","type":"journal-article","created":{"date-parts":[[2013,4,2]],"date-time":"2013-04-02T14:33:32Z","timestamp":1364913212000},"page":"887-893","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":44,"title":["High\u2010grade vaginal intraepithelial neoplasia: can we be selective about who we treat?"],"prefix":"10.1111","volume":"120","author":[{"given":"N","family":"Ratnavelu","sequence":"first","affiliation":[{"name":"Northern Gynaecological Oncology Centre Queen Elizabeth Hospital Gateshead UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A","family":"Patel","sequence":"additional","affiliation":[{"name":"Northern Gynaecological Oncology Centre Queen Elizabeth Hospital Gateshead UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"AD","family":"Fisher","sequence":"additional","affiliation":[{"name":"Northern Gynaecological Oncology Centre Queen Elizabeth Hospital Gateshead UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K","family":"Galaal","sequence":"additional","affiliation":[{"name":"Northern Gynaecological Oncology Centre Queen Elizabeth Hospital Gateshead UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P","family":"Cross","sequence":"additional","affiliation":[{"name":"Pathology Department Queen Elizabeth Hospital Gateshead UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R","family":"Naik","sequence":"additional","affiliation":[{"name":"Northern Gynaecological Oncology 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