Laser vaporization in the treatment of cervical intraepithelial neoplasia

Ablative cryotherapy and laser vaporization therapy attempt to eradicate the cervical transformation zone in order to eliminate cervical intraepithelial neoplasia and to reduce the risk of invasive cancer. We reviewed the literature on both methods and our own experience with laser therapy. Review of the records of 4,557 initial cryosurgical patients as compared to those of 1,505 initial laser patients revealed cure rates of 12% and 13.8%, respectively (no significant difference, p greater than 0.14). Multiple treatments in 533 cryosurgery and 1,775 laser patients revealed cure rates of 11% and 2.6%, respectively (p less than 0.0001). Enhanced accessibility of the new squamocolumnar junction following laser surgery may result in improved early detection of initial treatment failures and significantly improve the success rates of retreatment. If so, a reduction in the development of invasive cancer in laser-treated patients may occur.