Loop Diathermy to Replace Conization in the Conservative Treatment of In Situ Cancer of the Uterine Cervix

ABSTRACT

Retrospective data are analyzed from 217 patients conservatively treated for in situ cervical cancer, as diagnosed by colposcopically directed biopsies. One hundred twenty-four patients were treated by diathermy loop (57%), 43 patients were submitted to laser vaporization or diathermocoagulation (19.9%), and 50 patients (23%) had a surgical cone. The outpatient treatment never had to be stopped for pain or hemorrhage. After treatment, every patient had a periodic colposcopic and cytologic follow-up (mean follow-up 48 months). The cure rates were similar for the three therapy methods (94% overall, 93% diathermy loop, 96% surgical cone, and 95.4% laser or diathermocoagulation). Relapses were successfully treated, again with conservative therapy. Histologic examination of the surgical specimen was always possible for both the diathermy loop treatment and the surgical cone. The discordance between the preoperative biopsy and the postsurgical examination was 27% and 18% for diathermy loop and conization, respectively (not statistically significant). In 3 cases, a microinvasion was detectable in the specimen, and 1 patient had an associated cervical adenocarcinoma. The diathermy loop appears to be a reliable therapy for almost all patients with CIN 3. (J GYNECOL SURG 10:235, 1994)