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Sixty‐one women with vulvar dysplasia or carcinoma in situwere treated with local laser excision of the initial lesion and of the recurrences, and followed at intervals of from 3 increasing to 12 months. Recurrences were observed in 16 (26%) patients. No case of invasive carcinoma was seen. Patients with recurrences were significantly younger than those without (p<0.02, median age 42.5 and 54 years, respectively). The resection borders were significantly more often involved in the initial lesions in the group with recurrences (36%) than in the group without (9%) (p<0.014). All lesions were classified according to the WHO (mild, moderate, severe dysplasia or carcinoma in situ) and Toki et al.(1991) (warty, basaloid, combined warty/basaloid or mixed (warty, basaloid and simple). No pure types of Toki(1991) could be demonstrated. There were no differences regarding recurrences in any of these groups. HPV DNA was detected in the initial lesions by PCR in 50/56 (89%) (44 with HPV type 16 and 6 with HPV type 33) and by ISH in 23/61 (38%). The same type of HPV could be demonstrated in all first recurrences except in two, where HPV type 33 was shown in specimens harboring HPV type 16 in the initial lesions. In one of these cases, HPV type 16 could again be demonstrated in the second and final recurrence. In no specimen was more than one type of HPV detected. The results indicate that the most important parameter in predicting the recurrence of vulvar dysplasia or carcinoma in situis the involvement of the resection borders. The location of the lesion, the degree and type of dysplasia, and the type of HPV seem to play a minor role. Local excision and subsequent intensive control with removal of any visible new lesion probably prevents development of vulvar invasive carcinoma.

To evaluate the inhibitory effect of tranexamic acid (AMCA) on increased fibrinolyctical activity in connection with conisatio colli uteri we have carried out a randomized, double-blind study with patients operated upon partly with an open method of operation (80 patients) and partly with modified Sturmdorff sutures (150 patients). In connection with the open method the frequency of late bleeding decreased from. 17.5% to 2.5%, which is significant. The corresponding decrease in connection with the other method was from 10.7% to 4.1%. This material was not sufficiently large to verify significance. The side effects of the prophylactic treatment with AMCA were few.The study indicates that AMCA affords good protection against late bleeding in conisatio colli uteri.

A total of 90 patients has been treated with Treosulfan. The minimum follow-up period was 6 months. Distribution according to age and clinical stages corresponds to what is usually found. The treatment with Treosulfan was given in interrupted causes. The only serious side effect is a depression of the bone-marrow function. Apart from this, Treosulfan is well tolerated and in most cases the treatment can be carried out in the open ward. It is striking that the general condition of the patients very often was improved considerably. Five patients suffering from disseminated cancer apparently were cured. An excellent effect on ascites was seen since a complete disappearance of ascites was seen in 17 out of 27 patients with serous carcinoma and a transient improvement in six. There was hardly any effect of the treatment of the patients in the terminal stage of the disease. In stage III the average survival time for patients who died of the disease was proportional with the degree of response, viz.: Excellent response: 20.4 months, good response: 15.7 months and no or poor response: 6.0 months.