Cryosurgery for dysplasia of the uterine ectocervix. A randomized study of the efficacy of the single- and double-freeze techniques.
This prospective, randomized study of 142 women with mild or moderate dysplasia of the uterine ectocervix shows that the double-freeze technique is significantly more effective than the single-freeze technique, the recurrence rates being, respectively, 6.2% and 16.3%. The highest recurrence rate was found in the group treated with a single freeze and having the most extensive portio involvement. All patients were examined colposcopically before cryosurgery in order to exclude patients with lesions extending into the cervical canal and in order to evaluate the size of the lesion. Recurrent lesions were usually diagnosed within the first year (75%) and in only one patient more than 2 years after treatment. None of the patients developed invasive cancer. The mean follow-up period was 27 months (24-42 months). We consider cryosurgery to be an acceptable treatment for selected patients. Our criteria for entry were mild or moderate dysplasia of the uterine ectocervix, and colposcopic visualization of the entire transformation zone to ensure that the lesion does not extend into the cervical canal. Our experience from the present study is that the following criteria should be added: the portio involvement must not be too extensive and the patient must agree to follow-up examination. When these conditions are fulfilled, future treatment in our department will consist of a double freeze extending 3 mm beyond the lesion, with a thaw interval of 4 min.
D000293:Adolescent; D000328:Adult; D003452:Cryosurgery / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D011446:Prospective Studies; D011897:Random Allocation; D012008:Recurrence; D002578:Uterine Cervical Dysplasia / Q000601:surgery*