The treatment of cervical intraepithelial neoplasia by cone biopsy.

Between 1968 and 1976, 175 patients with severe dysplasia or carcinoma in situ were treated at the University of California, San Francisco. One hundred fourteen underwent therapeutic conization while 61 were treated definitely by hysterectomy. Bleeding was the main complication of cone biopsy. It occurred in 9.9% of all conizations, but only 2% of patients required transfusion. Although follow-up has been relatively short, two patients treated by therapeutic conization, who were lost to follow-up, subsequently developed recurrent invasive cancer and four have developed recurrent carcinoma in situ or severe dysplasia. One patient treated by hysterectomy has developed metastatic cancer and one has had a recurrence of severe dysplasia at the vaginal vault. There have been 32 pregnancies following cone biopsy with no increase in abortion or prematurity.