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Management of cervical neoplasia: a 13-year experience with cryotherapy and laser
V L Persad1, M A Pierotic, F B Guijon
1Department of Obstetrics, Gynecology & Reproductive Sciences University of Manitoba, RS-4, 810 Sherbrook Street, Winnipeg, Manitoba, Canada R3A 1R8.
Objective:
To evaluate whether cryotherapy is as effective as laser therapy in treating cervical intraepithelial neoplasia (CIN), and to determine the optimal time for follow up.
Materials And Methods:
Patients with biopsy-proven CIN were treated with cryotherapy or laser therapy. Specific data, including grade of CIN, rate of recurrence, and time to recurrence, were compared between the groups.
Results:
From 2240 eligible patients, 1126 were treated with laser and 1114 with cryotherapy. Ninety-two percent of patients in the laser group and 91.6% in the cryotherapy group had no evidence of CIN after a median follow up of 60 months. The 183 patients with recurrent/persistent disease were retreated with the same treatment modality as initially received. Eighty-seven of the 90 (96.7%) patients retreated with laser and 90 of the 93 patients (96.8%) retreated with cryotherapy had no further evidence of CIN. The majority (128 out of 183; 75.4%) of recurrent/persistent disease was detected within 18 months after treatment.
Conclusions:
CIN can be treated with similar success by cryotherapy or laser ablation. Optimal follow up would be two years for CIN1 lesions and five years for CIN2/3 lesions.

