Cervical laser vaporization for women with cervical intraepithelial neoplasia-3.

Abstract

OBJECTIVE:

This study evaluated outcomes of laser vaporization of the cervix for women with cervical intraepithelial neoplasia (CIN)-3.

METHODS:

We retrospectively reviewed 161 consecutive patients with CIN3 who were treated with cervical laser vaporization between January 2008 and December 2012. At each follow-up visit, histologically confirmed CIN2, CIN3 and invasive carcinoma were defined as treatment failures, as were high-grade squamous intraepithelial lesion (HSIL) or atypical squamous cells that cannot exclude HSIL with subsequent treatment or lost to follow-up. Primary endpoints included long-term follow-up (at least 5 years of regular hospital visits) and treatment failure rate. Treatment failure rates were estimated by the Kaplan-Meier method.

RESULTS:

Patients' median age was 31 years old. Median follow-up period was 67 months (interquartile range: 52-74 months). Over 5 years, 70.8% continued their follow-up visits, but significantly more patients aged ≥35 years did so (86.4%) than did those aged ≤34 years (61.8%, P = 0.0009). Treatment failure was observed in 14 (8.7%) patients, 1 of whom progressed to invasive cancer (0.6%). Cumulative treatment failure rates were 1-year: 5.1%, 2-year: 6.4% and 5-year: 9.5%. Among patients who suffered treatment failures, 57.1% initial failures occurred within the first year and 71.4% within the first 2 years.

CONCLUSIONS:

Long-term oncologic outcomes of cervical vaporization in CIN3 remain at a suboptimal level. The importance of a minimum of 5 years of regular hospital visits should be emphasized to patients with CIN3 who are candidates for cervical laser vaporization, especially those aged ≤34 years.

• Authors: Chisa Shimada, Yukiharu Todo, Hiroyuki Yamazaki, Shinichiro Minobe, Hidenori Kato
• Journal: Japanese journal of clinical oncology (Jpn J Clin Oncol) Vol. 49 Issue 5 Pg. 447-451 (May 01 2019) ISSN: 1465-3621 [Electronic] England
• PMID: 30796831 (Publication Type: Journal Article)
• Copyright: © The Author(s) 2019. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: [email protected].

Topics

• Adolescent
• Adult
• Aged
• Female
• Follow-Up Studies
• Humans
• Kaplan-Meier Estimate
• Laser Therapy
• Middle Aged
• Retrospective Studies
• Treatment Outcome
• Uterine Cervical Neoplasms (diagnosis, pathology, surgery)
• Young Adult
• Uterine Cervical Dysplasia (diagnosis, pathology, surgery)