Original ArticlesA randomized clinical trial of cryotherapy, laser vaporization, and loop electrosurgical excision for treatment of squamous intraepithelial lesions of the cervix
Section snippets
Study protocol
The study population was drawn from women referred to the University of Texas M. D. Anderson Cancer Center Colposcopy Clinic with the diagnosis of SIL, then called cervical intraepithelial neoplasia (CIN), between March 1992 and April 1994. Patients were eligible if they 1) were at least 18 years of age, 2) were using contraception, 3) had a negative pregnancy test, 4) had a biopsy-proven CIN lesion, 5) had negative findings on endocervical curettage, 6) had a satisfactory colposcopy
Results
Four hundred ninety-eight patients were assigned randomly to receive one of the three treatments. A total of 108 were excluded from analysis (four because they did not present for treatment, one because of other illness, one because of physician error in assignment, and 102 because they did not complete 4 months of follow-up), leaving 390 patients for analysis (139 cryotherapy, 121 laser vaporization, 130 loop electrosurgical excision procedure). No differences in age (P = .88) or grade (P =
Discussion
Previous nonrandomized and randomized studies of these treatments in the literature were not stratified by prognostic variables; thus, differences in these variables could have accounted for differences in failure rates. The case series that have reported on patients treated with these modalities have high dropout rates, and none were analyzed using statistical methods accounting for the amount of time patients were followed. The nonrandomized and randomized studies have short follow-up (Table
References (13)
- et al.
Potential of cervical electrosurgical excision procedure for diagnosis and treatment of cervical intraepithelial neoplasia
Gynecol Oncol
(1995) - et al.
Loop electrosurgical excision procedure for squamous intraepithelial lesions of the cervixAdvantages and potential pitfalls
Obstet Gynecol
(1996) - et al.
A study of cryosurgery and the CO2 laser in treatment of carcinoma in situ (CIN III) of the uterine cervix
Gynecol Oncol
(1985) - et al.
Laser or cryotherapy for cervical intraepithelial neoplasiaA randomized study to compare efficacy and side effects
Gynecol Oncol
(1985) - et al.
Prospective randomized trial of LLETZ versus laser ablation in patients with cervical intraepithelial neoplasia
Gynecol Oncol
(1994) Preinvasive diseases of the female genital tract
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The authors thank Robert Barr, MD, for helpful comments and the Business and Professional Women’s Association of Houston, Texas, for financial support.