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Cervical Intraepithelial Neoplasia III: Long-Term Outcome After Cold-Knife Conization With Clear Margins

From the Department of Obstetrics and Gynecology, University of Graz, Graz, Austria.

Address reprint requests to: Olaf Reich, MD, Department of Obstetrics and Gynecology, University of Graz Auenbruggerplatz, 14 A-8036 Graz Austria, E-mail: olaf.reich{at}kfunigraz.ac.at

Objective: To evaluate the long-term outcome of patients with severe cervical intraepithelial neoplasia or squamous cell carcinoma in situ (CIN III) after cold-knife conization with clear margins.

Methods: A total of 4417 women (mean age 36, range 18–72 years) with histologically confirmed CIN III had cold-knife conization with clear margins at our institution between 1970 and 1994. All patients were followed up with colpos-copy, cytology, and pelvic examination for a mean of 18 years (range 5–30years).

Results: New high-grade squamous intraepithelial lesions (SILs) (CIN II and III) developed in 15 (0.35%) patients (mean age 35, range 25–65 years) after a median of 107 (range 40–201) months. A total of 4402 (99.65%) patients (mean age 36, range 18–72 years) were free of high-grade SILs after a mean follow-up of 18 (range 5–30) years. High-grade glandular intraepithelial lesions developed in two (0.05%) patients 14 and 17 years after conization. Twelve (0.3%) patients had metachronous vulvar intraepithelial neoplasia (VIN) grade III or vaginal intraepithelial neoplasia (VAIN) grade III, and one (0.02%) patient had invasive vaginal carcinoma 10 years after conization.

Conclusion: Cold-knife conization with clear margins was an adequate method to definitively treat CIN III.

This article has been cited by other articles:

				O. Reich, M. Lahousen, H. Pickel, K. Tamussino, and R. Winter Cervical Intraepithelial Neoplasia III: Long-Term Follow-Up After Cold-Knife Conization With Involved Margins Obstet. Gynecol., February 1, 2002; 99(2): 193 - 196. [Abstract] [Full Text] [PDF]