Risk factors for treatment failure of CO2 laser vaporization in cervical intraepithelial neoplasia 2

Arch Gynecol Obstet. 2014 Jul;290(1):115-9. doi: 10.1007/s00404-014-3148-1. Epub 2014 Jan 24.

Abstract

Purpose: The aim of our study was to evaluate the risk factors for treatment failure of CO2 laser vaporization in patients with cervical intraepithelial neoplasia 2 (CIN2).

Methods: Medical records of patients who received either shallow or deep CO2 laser vaporization with biopsy-proven CIN2 during March 2007 to April 2011 were reviewed retrospectively. After laser vaporization, liquid-based cytology and human papilloma virus (HPV) DNA testing were checked in every follow-up visit. Treatment failure was defined when the follow-up biopsy was more than CIN2, needing secondary surgical treatment.

Results: During that period, 141 patients with CIN2 underwent CO2 laser vaporization. After laser ablation, 14 of 141 women needed the secondary treatment, a success rate of laser vaporization of 90.1 %. In multivariate analysis, the previous loop electrosurgical excision procedure (LEEP) history (adjusted OR = 13.649; P value = 0.025) and the ablation depth (adjusted OR = 11.279; P value = 0.006) were independent factors associated with treatment failure.

Conclusion: Both ablation depth and previous LEEP history were the important factors increasing the risk for the treatment failure of CO2 laser vaporization in CIN2.

Publication types

  • Evaluation Study

MeSH terms

  • Adult
  • Aged
  • Biopsy
  • Colposcopes
  • Female
  • Human Papillomavirus DNA Tests
  • Humans
  • Laser Therapy / adverse effects
  • Laser Therapy / methods*
  • Lasers, Gas / therapeutic use*
  • Middle Aged
  • Multivariate Analysis
  • Retrospective Studies
  • Risk Factors
  • Treatment Failure*
  • Uterine Cervical Dysplasia / pathology
  • Uterine Cervical Dysplasia / surgery*
  • Uterine Cervical Neoplasms / pathology
  • Uterine Cervical Neoplasms / surgery*