Risk factors for treatment failure of CO2 laser vaporization in cervical intraepithelial neoplasia 2.
OBJECTIVE
The aim of our study was to evaluate the risk factors for treatment failure of CO2 laser vaporization in patients with cervical intraepithelial neoplasia 2 (CIN2).


METHODS
Medical records of patients who received either shallow or deep CO2 laser vaporization with biopsy-proven CIN2 during March 2007 to April 2011 were reviewed retrospectively. After laser vaporization, liquid-based cytology and human papilloma virus (HPV) DNA testing were checked in every follow-up visit. Treatment failure was defined when the follow-up biopsy was more than CIN2, needing secondary surgical treatment.


RESULTS
During that period, 141 patients with CIN2 underwent CO2 laser vaporization. After laser ablation, 14 of 141 women needed the secondary treatment, a success rate of laser vaporization of 90.1 %. In multivariate analysis, the previous loop electrosurgical excision procedure (LEEP) history (adjusted OR = 13.649; P value = 0.025) and the ablation depth (adjusted OR = 11.279; P value = 0.006) were independent factors associated with treatment failure.


CONCLUSIONS
Both ablation depth and previous LEEP history were the important factors increasing the risk for the treatment failure of CO2 laser vaporization in CIN2.
Department of Obstetrics and Gynecology, CHA Gangnam Medical Center, CHA University, 650-9, Yoksam-dong, Gangnam-gu, Seoul, 135-913, Korea.
Bo Sung
BS
Yoon
Seok Ju
SJ
Seong
Taejong
T
Song
Mi-La
ML
Kim
Mi Kyoung
MK
Kim
D000328:Adult; D000368:Aged; D001706:Biopsy; D020681:Colposcopes; D005260:Female; D061809:Human Papillomavirus DNA Tests; D006801:Humans; D053685:Laser Therapy / Q000009:adverse effects / Q000379:methods*; D054020:Lasers, Gas / Q000627:therapeutic use*; D008875:Middle Aged; D015999:Multivariate Analysis; D012189:Retrospective Studies; D012307:Risk Factors; D017211:Treatment Failure; D002583:Uterine Cervical Neoplasms / Q000473:pathology / Q000601:surgery*; D002578:Uterine Cervical Dysplasia / Q000473:pathology / Q000601:surgery*