Introduction/Background Nowadays there is no consensus on the size of surgical margins of vulvar H-SIL. Keeping the healthy margin of 5 mm is generally recommended in literature, but the robust data supporting this statement are missing.

Methodology The prospective study included women diagnosed with HPV-associated vulvar epithelial neoplasia from 10/2016 to 1/2022. A total of 65 women were included. After surgical treatment, the women were distributed to groups according to surgical margins and were followed-up at regular intervals.

Results Seventeen women (26%) diagnosed with HPV-associated vulvar intraepithelial neoplasia were under 49 years, whereas 48 women (74%) were older than 49 years. Recurrence rates of HPV-associated precancers were 12,3%, 1,5% and 3,1% in excisions with positive margins, up to 1 mm peripheral margins and 1–3 mm peripheral margins, respectively. The risk of recurrence when the lesion reaches the margins is statistically significant, compared to a healthy margin of 1–3 mm (p=0,0363).

Conclusion Keeping the minimal healthy margin (1–3 mm) seems to be an acceptable risk of recurrence of HPV-associated vulvar intraepithelial neoplasia with positive cosmetic effect and minimal risk of disturbing the psychosexual function of women. Long-term regular follow-up is necessary.

Disclosures I have no potential conflict of interest to report.