Management of Cervical Neoplasia: A 13-Year Experience with Cryotherapy and Laser

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.