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348 Cervical laser vaporization for women with high grade squamous intraepithelial lesion of the cervix
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  1. K Minowa,
  2. Y Todo,
  3. H Kurosu,
  4. R Yamada,
  5. T Turuta,
  6. S Minobe and
  7. H Kato
  1. Hokkaido cancer center, Japan

Abstract

Objective This study evaluated outcomes of laser vaporization of the cervix for women with cervical intraepithelial neoplasia (CIN)-2 or 3.

Methods We retrospectively reviewed 300 consecutive patients with CIN2/CIN3 who were treated with cervical laser vaporization between January 2008 and December 2014. 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 (ASC-H) with subsequent treatment or lost to follow-up. Primary endpoints included long-term follow-up (at least five years of regular hospital visits) and treatment failure rate. Treatment failure rates were estimated by the Kaplan–Meier method.

Results Patients’ median age was 32 years old. Median follow-up period was 70 months (interquartile range: 51 – 84 months). Eighty-seven patients had CIN2 and 213 CIN3.

Over 5 years, 72.0% continued their follow-up visits, but significantly more patients aged ≥ 35 years did so (78.9%) than did those aged ≤ 34 years (66.9%). Treatment failure was observed in 23 patients (2 CIN2 and 21 CIN3), 3 of whom progressed to invasive cancer (1.1%). Four (21.1%) initial failures occurred after the first 5 years.

Cumulative treatment failure rates were 2-year: 96.0%, 5-year: 93.6%, and 8-year: 89.6%.

Conclusions The importance of ≥ 5 years of regular hospital visits should be emphasized to patients with CIN2/3 who are candidates for cervical laser vaporization, especially those aged ≤ 34 years.

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