The Journal of reproductive medicine · 2009
Management of relapsing cervical intraepithelial neoplasia.
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Rodolakis Alexandros, Thomakos Nikolaos, Haidopoulos Demetrios, Antsaklis Aris
Аннотация
OBJECTIVE: To evaluate relapsing cervical intraepithelial neoplasia (CIN) and establish the criteria of recurrence to assess management by laser CO2.
STUDY DESIGN: 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.
CONCLUSION: 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.
STUDY DESIGN: 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.
CONCLUSION: 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.