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Superficial laser vulvectomy. V. Surgical debulking is enhanced by adjuvant systemic interferon.

Abstract
Skillful laser ablation can remove any volume of human papillomavirus-associated vulvar disease but cannot prevent reactivation of the surrounding latent viral reservoir during postoperative healing. Conversely, interferon and 5-fluorouracil are relatively ineffective as primary therapies in clearing bulky lesions. In this study of 71 assessable patients, topical 5-fluorouracil and systemic interferon injections were used postoperatively. Success rates within the adjuvant 5-fluorouracil and laser alone arms were essentially the same (9 of 18 vs 8 of 20). In contrast, outcome in the interferon group was significantly better than that for the other two arms combined (27 of 33 [82%] vs 17 of 38 [45%]; chi 2 10.31; p less than 0.002). Moreover, 18 of 21 failures (86%) in the first two arms and 3 of 6 failures (50%) in the interferon arm were "rescued" from the need for a second laser surgical procedure by crossover to either the 1 or 3 MIU interferon regimen. Results from this open-label, randomized clinical trial suggest that even a relatively low dose of recombinant interferon, used in combination with effective surgical debulking, can markedly reduce the risk of postoperative recurrence.
AuthorsR Reid, M D Greenberg, D J Pizzuti, K H Omoto, L H Rutledge, W Soo
JournalAmerican journal of obstetrics and gynecology (Am J Obstet Gynecol) Vol. 166 Issue 3 Pg. 815-20 (Mar 1992) ISSN: 0002-9378 [Print] United States
PMID1372470 (Publication Type: Clinical Trial, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
Chemical References
  • Interferons
  • Fluorouracil
Topics
  • Administration, Topical
  • Condylomata Acuminata (pathology, therapy)
  • Female
  • Fluorouracil (therapeutic use)
  • Humans
  • Interferons (therapeutic use)
  • Laser Therapy
  • Papillomaviridae
  • Tumor Virus Infections (pathology, therapy)
  • Vulva (surgery)

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