5-Fluorouracil Promising for Vaginal Intraepithelial Neoplasia

TUESDAY, Nov. 21, 2017 (HealthDay News) -- 5-fluorouracil is associated with a 74 percent success rate as the initial treatment modality for high-grade intraepithelial vaginal dysplasia, according to a study published online Nov. 7 in Obstetrics & Gynecology.

Stephen Fiascone, M.D., from Brigham and Women's Hospital in Boston, and colleagues retrospectively reviewed the cases of women referred to a single center for management of high-grade vaginal intraepithelial neoplasia between April 1994 and May 2016 to assess the success rates of 5-fluorouracil, excision, and laser ablation as the initial and secondary management strategies.

The researchers found that 47 patients were treated initially with 5-fluorouracil, 35 were treated with excision, and 22 were treated with laser ablation. The groups were similar demographically. There was no recurrence in 35 women treated with 5-fluorouracil (74 percent), 20 treated with excision (57 percent), or nine treated with laser ablation (41 percent). Eight of the 13 patients treated with 5-fluorouracil for recurrence did not experience a second recurrence. Side effects were reported in nine of 58 patients (16 percent) ever treated with 5-fluorouracil, most commonly irritation and dyspareunia.

"The optimal treatment strategy for women with recurrent or persistent vaginal intraepithelial neoplasia is unclear from the current literature, and the data presented here show that topical 5-fluorouracil may have an important role in this context, especially given the morbidity associated with repeated vaginal surgeries," the authors write.

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