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Volume 121, Issue 1, Pages (April 2011)

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1 Volume 121, Issue 1, Pages 157-162 (April 2011)
Treatment of vulvar intraepithelial neoplasia with topical imiquimod: Seven years median follow-up of a randomized clinical trial  Annelinde Terlou, Manon van Seters, Patricia C. Ewing, Neil K. Aaronson, Chad M. Gundy, Claudia Heijmans-Antonissen, Wim G.V. Quint, Leen J. Blok, Marc van Beurden, Theo J.M. Helmerhorst  Gynecologic Oncology  Volume 121, Issue 1, Pages (April 2011) DOI: /j.ygyno Copyright © 2010 Elsevier Inc. Terms and Conditions

2 Fig. 1 Clinical response at 20weeks, 12months and >5years after start of imiquimod treatment. aClinical response at 20weeks and 12months was classified as no response (reduction in lesion size of 25% or less), weak partial response (PR, 26–75% reduction), strong partial response (76–99% reduction), or complete response (CR, 100% reduction). bOne patient with a weak partial response was lost to follow-up at 12months because of unrelated medical problems, but this patient did show up for long-term follow-up. Another patient with a weak partial response progressed to invasion (<1mm) at 7months. She underwent surgery before follow-up at 12months, so total lesion size was not measured at 12months. cOne patient developed squamous cell carcinoma at 24months and was treated with local vulvar excision and lymphadenectomy. dOne patient developed microinvasive squamous cell carcinoma at 38months and was treated with local vulvar excision. Gynecologic Oncology  , DOI: ( /j.ygyno ) Copyright © 2010 Elsevier Inc. Terms and Conditions

3 Fig. 2 Clinical results before imiquimod treatment, 4weeks after treatment and at >5years follow-up. Clinical pictures of three patients with HPV DNA-positive VIN showing results before treatment (T=0), 4weeks after treatment (T=20weeks) and >5years after treatment. All three patients showed complete regression of the lesion. Gynecologic Oncology  , DOI: ( /j.ygyno ) Copyright © 2010 Elsevier Inc. Terms and Conditions

4 Fig. 3 Mental health, global quality of life, body image and sexual functioning. Scores (ranging from 0 to 100, mean±SD) on mental health, global quality of life, body image and sexual functioning in patients with (Table 1, patients 1–10) and without (Table 1, patients 11–24) long-term complete response after imiquimod treatment. aPatients with long-term complete response had a higher score on global quality of life (QoL) than patients with residual disease and/or recurrence (86±14 vs. 70±17, P=0.025, one-way analysis of variance). Gynecologic Oncology  , DOI: ( /j.ygyno ) Copyright © 2010 Elsevier Inc. Terms and Conditions


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