May 29th, 2022

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Management of Relapsing Cervical Intraepithelial Neoplasia
Authors:  Alexandros Rodolakis, M.D., Ph.D., Nikolaos Thomakos, M.D., Ph.D., Demetrios Haidopoulos, M.D., Ph.D., and Aris Antsaklis, M.D., Ph.D.
  OBJECTIVE: To evaluate relapsing cervical intraepithelial neoplasia (CIN) and establish the criteria of recurrence to assess management by laser CO2.

STUDY DESIGN: Patients with histologically proved CIN after a primary conservative approach were the study population. Disease relapse was considered as residual or recurrent if diagnosed within or after the first year of follow-up.

RESULTS: There were 333 patients assessed in our study. Residual disease was found in 80 patients (24%) and recurrent disease in 253 patients (76%). Histologic findings were compatible with CIN 2-3 in 127 and with CIN 1 in 206 patients. Laser CO2 conization was offered to 240 patients, laser ablation to 10 patients and combination treatment to 31 patients, whereas 52 patients were assigned to follow-up. Involved resection margins were present in 37 patients, but only when the endocervical margin was involved was there a significant association with recurrence rate.

CONCLUSION: Relapsing CIN creates difficulties in management; we recommend that patients should be treated in tertiary centers with high expertise. Laser CO2 seems to be a safe and efficacious method for treating relapsing CIN. (J Reprod Med 2009;54:499-505)
Keywords:  cervical intraepithelial neoplasia, laser CO2, relapse
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