{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T00:44:20Z","timestamp":1787013860307,"version":"build-2736575974"},"reference-count":33,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2024,2,21]],"date-time":"2024-02-21T00:00:00Z","timestamp":1708473600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2024,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Differentiated vulvar intraepithelial neoplasia (dVIN) is a high\u2010risk preinvasive vulvar lesion and precursor of human papillomavirus\u2010independent vulvar squamous cell carcinoma (VSCC). Due to its rarity, literature data on its malignant potential are scant. The aim of the study is to assess the risk of developing VSCC in patients surgically treated for dVIN not associated with VSCC (solitary dVIN) and the risk of VSCC recurrence in patients treated for dVIN associated with VSCC (dVIN\u2010VSCC) at first diagnosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Material and methods<\/jats:title>\n                    <jats:p>A historical cohort study was performed in a northern Italy referral center for vulvar neoplasms. All consecutive women surgically treated for histologically confirmed dVIN from 1994 to 2021 were collected. Primary outcome was cancer risk or recurrent cancer risk, secondary outcomes were risk factors associated with VSCC development or recurrence. Kaplan\u2013Meier method and log\u2010rank test were used to estimate cancer risk or recurrent cancer risk differences and uni\u2010 and multivariate Cox regression analyses to identify risk factors associated with VSCC development in solitary dVIN and recurrence of dVIN\u2010VSCC.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Seventy\u2010six patients with dVIN at preoperative biopsy were included: at excisional specimens 44 were solitary dVIN and 32 were dVIN\u2010VSCC. The absolute risk of VSCC development after solitary dVIN treatment was 43.2% with median time to to VSCC diagnosis of 25.4\u2009months (range 3.5\u2013128.0\u2009months). VSCC recurrence absolute risk in treated dVIN\u2010VSCC patients was 31.3% with median time to VSCC recurrence of 52.9\u2009months (range 6.5\u201394.8\u2009months). At uni\u2010 and multivariate regression analyses, only compliant topical ultrapotent corticosteroid treatment after solitary dVIN excision showed an ability to prevent VSCC development. No protective effect by corticosteroid treatment was shown for VSCC recurrence in dVIN\u2010VSCC patients. Smoking was associated with higher cancer recurrence risk in dVIN\u2010VSCC patients on both uni\u2010 and multivariate regression analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Patients with dVIN have a high risk of developing both primary and recurring VSCC. Early recognition, long\u2010term follow up, and compliant ultrapotent topical corticosteroid treatment are recommended.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/aogs.14814","type":"journal-article","created":{"date-parts":[[2024,2,21]],"date-time":"2024-02-21T20:59:25Z","timestamp":1708549165000},"page":"1175-1182","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Differentiated vulvar intraepithelial neoplasia long\u2010term follow up and prognostic factors: An analysis of a large historical cohort"],"prefix":"10.1111","volume":"103","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3041-1201","authenticated-orcid":false,"given":"Niccol\u00f2","family":"Gallio","sequence":"first","affiliation":[{"name":"Division of Gynecology and Obstetrics, Department of Surgical Sciences, City of Health and Science University Hospital, S. Anna Hospital University of Turin  Turin Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1573-3114","authenticated-orcid":false,"given":"Mario","family":"Preti","sequence":"additional","affiliation":[{"name":"Division of Gynecology and Obstetrics, Department of Surgical Sciences, City of Health and Science University Hospital, S. Anna Hospital University of Turin  Turin Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ronald W.","family":"Jones","sequence":"additional","affiliation":[{"name":"Retired Clinical Professor  Auckland New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fulvio","family":"Borella","sequence":"additional","affiliation":[{"name":"Division of Gynecology and Obstetrics, Department of Surgical Sciences, City of Health and Science University Hospital, S. Anna Hospital University of Turin  Turin Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linn","family":"Woelber","sequence":"additional","affiliation":[{"name":"Department of Gynecology University Medical Center Hamburg\u2010Eppendorf  Hamburg Germany"},{"name":"Dysplasia Center Hamburg Colposcopy Clinic at the Jerusalm Hospital  Hamburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9887-7668","authenticated-orcid":false,"given":"Luca","family":"Bertero","sequence":"additional","affiliation":[{"name":"Department of Medical Sciences, Pathology Unit, City of Health and Science University Hospital University of Turin  Turin Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Urru","sequence":"additional","affiliation":[{"name":"Department of Cardiac, Thoracic, Vascular Sciences and Public Health, Unit of Biostatistics, Epidemiology and Public Health University of Padua  Padua Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leonardo","family":"Micheletti","sequence":"additional","affiliation":[{"name":"Division of Gynecology and Obstetrics, Department of Surgical Sciences, City of Health and Science University Hospital, S. Anna Hospital University of Turin  Turin Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federica","family":"Zamagni","sequence":"additional","affiliation":[{"name":"Emilia\u2010Romagna Cancer Registry Romagna Cancer Institute, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) Dino Amadori  Forl\u00ec Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federica","family":"Bevilacqua","sequence":"additional","affiliation":[{"name":"Division of Gynecology and Obstetrics, Department of Surgical Sciences, City of Health and Science University Hospital, S. Anna Hospital University of Turin  Turin Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierluigi","family":"Tondo","sequence":"additional","affiliation":[{"name":"Division of Gynecology and Obstetrics, Department of Surgical Sciences, City of Health and Science University Hospital, S. Anna Hospital University of Turin  Turin Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benedetta","family":"Pollano","sequence":"additional","affiliation":[{"name":"Division of Gynecology and Obstetrics, Department of Surgical Sciences, City of Health and Science University Hospital, S. Anna Hospital University of Turin  Turin Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paola","family":"Cassoni","sequence":"additional","affiliation":[{"name":"Department of Medical Sciences, Pathology Unit, City of Health and Science University Hospital University of Turin  Turin Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiara","family":"Benedetto","sequence":"additional","affiliation":[{"name":"Division of Gynecology and Obstetrics, Department of Surgical Sciences, City of Health and Science University Hospital, S. Anna Hospital University of Turin  Turin Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,2,21]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.33198"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygyno.2020.03.013"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.30821"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13027-020-00286-8"},{"key":"e_1_2_12_6_1","first-page":"257","volume-title":"Female Genital Tumours: WHO Classification of Tumours","author":"WHO Classification of Tumours Editorial Board","year":"2020"},{"key":"e_1_2_12_7_1","first-page":"1","article-title":"Is there a place for immune checkpoint inhibitors in vulvar neoplasms? A state of the art review","volume":"22","author":"Borella F","year":"2021","journal-title":"Int J Mol Sci"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygyno.2022.06.014"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.maturitas.2023.04.010"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.30621"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1155\/2011\/951250"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/PGP.0000000000000280"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000001285"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(196103\/04)14:2<318::AID-CNCR2820140212>3.0.CO;2-J"},{"key":"e_1_2_12_15_1","first-page":"45","article-title":"Cutaneous vulvar diseases","volume":"9","author":"Hart WR","year":"1977","journal-title":"Contemp Ob Gyn"},{"key":"e_1_2_12_16_1","first-page":"973","article-title":"Report of the ISSVD terminology committee","volume":"31","author":"Wilkinson EJ","year":"1986","journal-title":"J Reprod Med Obstet Gynecol"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/LGT.0000000000000572"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1136\/ijgc-2021-003262"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamadermatol.2015.0643"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.3390\/cancers14071822"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1097\/00003081-199134030-00020"},{"key":"e_1_2_12_22_1","first-page":"747","volume-title":"Vulva. AJCC Cancer Staging Manual","author":"American Joint Committee on Cancer","year":"2017"},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.1002\/cam4.1633"},{"key":"e_1_2_12_24_1","doi-asserted-by":"publisher","DOI":"10.3390\/cancers13246170"},{"key":"e_1_2_12_25_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000478-200003000-00013"},{"key":"e_1_2_12_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejca.2008.11.037"},{"key":"e_1_2_12_27_1","doi-asserted-by":"publisher","DOI":"10.1097\/LGT.0000000000000248"},{"key":"e_1_2_12_28_1","doi-asserted-by":"publisher","DOI":"10.1097\/PGP.0000000000000375"},{"key":"e_1_2_12_29_1","first-page":"301","article-title":"High\u2010grade vulvar intraepithelial neoplasia: comprehensive characterization and long\u2010term vulvar carcinoma risk","volume":"301","author":"Thuijs NB","year":"2023","journal-title":"Histopathology"},{"key":"e_1_2_12_30_1","doi-asserted-by":"publisher","DOI":"10.1111\/IGC.0b013e3181a12fa2"},{"key":"e_1_2_12_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygyno.2019.05.010"},{"key":"e_1_2_12_32_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.34655"},{"key":"e_1_2_12_33_1","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/89.20.1516"},{"key":"e_1_2_12_34_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.34537"}],"container-title":["Acta Obstetricia et Gynecologica Scandinavica"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/aogs.14814","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,10]],"date-time":"2025-04-10T15:05:50Z","timestamp":1744297550000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1111\/aogs.14814"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,2,21]]},"references-count":33,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2024,6]]}},"alternative-id":["10.1111\/aogs.14814"],"URL":"https:\/\/doi.org\/10.1111\/aogs.14814","archive":["Portico"],"relation":{},"ISSN":["0001-6349","1600-0412"],"issn-type":[{"value":"0001-6349","type":"print"},{"value":"1600-0412","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,2,21]]},"assertion":[{"value":"2023-10-05","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-02-06","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-02-21","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}