title: Laser CO2 vaporization for high-grade cervical intraepithelial neoplasia: a long-term follow-up series.
abstract: 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.
authors.affiliation: Department of Gynecology, Perinatology and Human Reproduction, University of Florence, Florence, Italy.
authors.forename: Maria Grazia
authors.initials: MG
authors.lastname: Fallani
authors.forename: Carlo
authors.initials: C
authors.lastname: Penna
authors.forename: Massimiliano
authors.initials: M
authors.lastname: Fambrini
authors.forename: Mauro
authors.initials: M
authors.lastname: Marchionni
mesh_terms: 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*