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Cryosurgery for cervical intraepithelial neoplasia: 10-year follow-up
1Department of Obstetrics and Gynecology, Aalborg Hospital, Denmark.
Abstract:
Cryotherapy was performed for the treatment of CIN in 261 patients, who were followed for 5 to 10 years after treatment. The overall cure rate was 83.5%. Increasing grade of CIN and enocervical involvement significantly reduced the cure rate. In pure exocervical lesions, a 91% cure rate in patients with CIN II lesions and a 77.8% cure rate in CIN III patients were observed. In patients with endocervical involvement, the influence of grade of lesion was of no significance. Life-table calculations demonstrated an overall risk of persisting CIN during the first year of observation of 8.8%, compared to a risk of 0.8% during Years 6 to 10. Log-rank test showed a risk of recurrence in patients with CIN III lesions significantly higher than that in patients with CIN II lesions and also a higher risk in patients with endocervical involvement. There was no significant influence of age on cure rates. Endocervical involvement should be considered a contraindication to cryotherapy, and a careful follow-up schedule is mandatory if cryotherapy is to keep its position as a recommendable therapy in patients with CIN.