title: Virological and cytological clearance in laser vaporization and conization for cervical intra-epithelial neoplasia grade 3.
abstract: OBJECTIVE
  Cervical intra-epithelial neoplasia (CIN) is the precancerous stage of cervical cancer. Standard treatment for high-grade CIN is conization of the cervix. The risk of preterm birth following conization has been discussed recently. In contrast, laser vaporization is believed not to affect perinatal outcome, but the long-term effectiveness of each surgical procedure is still unclear. The aim of this prospective unmatched-cohort study was therefore to compare virological and cytological clearance and recurrence risk between conization and vaporization for CIN3.
  
  
  METHODS
  Subject consisted of CIN3 patients treated at the present hospital between 2007 to 2011 and followed up until December 2014. One hundred and one patients were treated with laser conization, and 137 with vaporization. The surgical procedure was selected on the basis of colposcopy, pathological grade and patient's hope for pregnancy.
  
  
  RESULTS
  There were no significant differences in cure rate, human papilloma virus (HPV) clearance rate or recurrence rates between the conization and vaporization groups. Risk ratio of recurrence for each surgical procedure adjusted for age and HPV persistence status were analyzed on Cox proportional hazards modeling. Recurrence risk ratio for patients treated by vaporization was 6.21 (95%CI: 0.65-59.19; P = 0.111) compared with conization and there were no significant differences. No adverse pregnancy outcome was observed in the vaporization group compared with conization.
  
  
  CONCLUSIONS
  Laser vaporization is useful for young patients with CIN3 who hope for pregnancy in the future.
authors.affiliation: Department of Obstetrics and Gynecology, NTT East Japan Sapporo Hospital, Sapporo, Japan.|Departments of Obstetrics and Gynecology, Sapporo Medical University School of Medicine, Sapporo, Japan.
authors.forename: Tasuku
authors.initials: T
authors.lastname: Mariya
authors.affiliation: Department of Obstetrics and Gynecology, NTT East Japan Sapporo Hospital, Sapporo, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Nishikawa
authors.affiliation: Department of Obstetrics and Gynecology, NTT East Japan Sapporo Hospital, Sapporo, Japan.
authors.forename: Kanae
authors.initials: K
authors.lastname: Sogawa
authors.affiliation: Department of Obstetrics and Gynecology, NTT East Japan Sapporo Hospital, Sapporo, Japan.
authors.forename: Riri
authors.initials: R
authors.lastname: Suzuki
authors.affiliation: Department of Obstetrics and Gynecology, NTT East Japan Sapporo Hospital, Sapporo, Japan.
authors.forename: Masae
authors.initials: M
authors.lastname: Saito
authors.affiliation: Department of Obstetrics and Gynecology, NTT East Japan Sapporo Hospital, Sapporo, Japan.
authors.forename: Akari
authors.initials: A
authors.lastname: Kawamata
authors.affiliation: Department of Obstetrics and Gynecology, NTT East Japan Sapporo Hospital, Sapporo, Japan.
authors.forename: Ayumi
authors.initials: A
authors.lastname: Shimizu
authors.affiliation: Department of Obstetrics and Gynecology, NTT East Japan Sapporo Hospital, Sapporo, Japan.
authors.forename: Takehito
authors.initials: T
authors.lastname: Nihei
authors.affiliation: Public Health, Sapporo Medical University School of Medicine, Sapporo, Japan.
authors.forename: Tomoko
authors.initials: T
authors.lastname: Sonoda
authors.affiliation: Departments of Obstetrics and Gynecology, Sapporo Medical University School of Medicine, Sapporo, Japan.
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Saito
mesh_terms: D000328:Adult; D019092:Conization / Q000379:methods*; D018572:Disease-Free Survival; D005260:Female; D005838:Genotype; D013509:Gynecologic Surgical Procedures / Q000379:methods*; D006801:Humans; D053685:Laser Therapy / Q000379:methods*; D060787:Neoplasm Grading; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis / Q000821:virology; D027383:Papillomaviridae / Q000235:genetics; D030361:Papillomavirus Infections / Q000150:complications*; D011247:Pregnancy; D011256:Pregnancy Outcome; D011446:Prospective Studies; D012307:Risk Factors; D012680:Sensitivity and Specificity; D016896:Treatment Outcome; D002578:Uterine Cervical Dysplasia / Q000175:diagnosis / Q000473:pathology* / Q000601:surgery* / Q000821:virology*
keywords: cervical intra-epithelial neoplasia grade 3; human papilloma virus; laser conization; laser vaporization