Laser CO2 vaporization for high-grade cervical intraepithelial neoplasia: a long-term follow-up series.
OBJECTIVE
The goal of this study was to evaluate the effectiveness of laser CO(2) vaporization for conservative treatment of ectocervical high-grade cervical intraepithelial neoplasia (CIN) particularly by the evaluation of the reappearance risk of disease in long-term follow-up.


METHODS
One hundred fifty-nine patients were submitted to CO(2) laser vaporization for high-grade CIN and followed up for a minimum of 5 years. Selection of cases, depth of ablation, complications, and cure rate (percentage of treated patients in whom there was no recurrent/persistent high-grade CIN at the 5-year follow-up examination) were retrospectively evaluated.


RESULTS
Selected cases for colposcopy were submitted to a 6-mm mean depth of vaporization without intra- or postoperative complications. The cure rate for a single treatment was 97.5% and a satisfactory colposcopic follow-up was possible in 99.4% of treated patients. No case of invasive carcinoma occurred after a mean follow-up of 7.1 years. Four cases (2.5%) were high-grade CIN persistence observed after a mean time of 3.75 months, suggesting incomplete destruction of the deepest part of the lesion involving the glandular crypt base.


CONCLUSIONS
Long-term follow-up proves that laser CO(2) vaporization still has a place in the treatment of CIN. In selected cases it represents a safe alternative for conization in the treatment of high-grade CIN, but colposcopic expertise is essential for adequate preoperative selection of cases.
Fallani
Maria Grazia
MG
Department of Gynecology, Perinatology and Human Reproduction, University of Florence, Florence, Italy.
Penna
Carlo
C
Fambrini
Massimiliano
M
Marchionni
Mauro
M
D003127:Colposcopy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053685:Laser Therapy / Q000379:methods*; D002583:Uterine Cervical Neoplasms / Q000601:surgery*; D002578:Uterine Cervical Dysplasia / Q000601:surgery*