title: Management of relapsing cervical intraepithelial neoplasia.
abstract: OBJECTIVE
  To evaluate relapsing cervical intraepithelial neoplasia (CIN) and establish the criteria of recurrence to assess management by laser CO2.
  
  
  METHODS
  Patients with histologically proved CIN after a primary conservative approach were the study population. Disease relapse was considered as residual or recurrent if diagnosed within or after the first year of follow-up.
  
  
  RESULTS
  There were 333 patients assessed in our study. Residual disease was found in 80 patients (24%) and recurrent disease in 253 patients (76%). Histologic findings were compatible with CIN 2-3 in 127 and with CIN 1 in 206 patients. Laser CO2 conization was offered to 240 patients, laser ablation to 10 patients and combination treatment to 31 patients, whereas 52 patients were assigned to follow-up. Involved resection margins were present in 37 patients, but only when the endocervical margin was involved was there a significant association with recurrence rate.
  
  
  CONCLUSIONS
  Relapsing CIN creates difficulties in management; we recommend that patients should be treated in tertiary centers with high expertise. Laser CO2 seems to be a safe and efficacious method for treating relapsing CIN.
authors.affiliation: First Department of Obstetrics and Gynecology, University of Athens, Athens, Greece. rodolaki@hol.gr
authors.forename: Alexandros
authors.initials: A
authors.lastname: Rodolakis
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Thomakos
authors.forename: Demetrios
authors.initials: D
authors.lastname: Haidopoulos
authors.forename: Aris
authors.initials: A
authors.lastname: Antsaklis
mesh_terms: D000328:Adult; D019092:Conization / Q000379:methods*; D005260:Female; D006801:Humans; D054020:Lasers, Gas / Q000627:therapeutic use*; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000601:surgery*; D012086:Reoperation / Q000379:methods; D002583:Uterine Cervical Neoplasms / Q000601:surgery*; D055815:Young Adult; D002578:Uterine Cervical Dysplasia / Q000601:surgery*