Management of cervical neoplasia: a 13-year experience with cryotherapy and laser.
OBJECTIVE
To evaluate whether cryotherapy is as effective as laser therapy in treating cervical intraepithelial neoplasia (CIN), and to determine the optimal time for follow up.


METHODS
Patients with biopsy-proven CIN were treated with cryotherapy or laser therapy. Specific data, including grade of CIN, rate of recurrence, and time to recurrence, were compared between the groups.


RESULTS
From 2240 eligible patients, 1126 were treated with laser and 1114 with cryotherapy. Ninety-two percent of patients in the laser group and 91.6% in the cryotherapy group had no evidence of CIN after a median follow up of 60 months. The 183 patients with recurrent/persistent disease were retreated with the same treatment modality as initially received. Eighty-seven of the 90 (96.7%) patients retreated with laser and 90 of the 93 patients (96.8%) retreated with cryotherapy had no further evidence of CIN. The majority (128 out of 183; 75.4%) of recurrent/persistent disease was detected within 18 months after treatment.


CONCLUSIONS
CIN can be treated with similar success by cryotherapy or laser ablation. Optimal follow up would be two years for CIN1 lesions and five years for CIN2/3 lesions.
Persad
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VL
Department of Obstetrics, Gynecology & Reproductive Sciences University of Manitoba, RS-4, 810 Sherbrook Street, Winnipeg, Manitoba, Canada R3A 1R8.
Pierotic
M A
MA
Guijon
F B
FB