LOOP DIATHERMY TO REPLACE CONIZATION IN THE CONSERVATIVE TREATMENT OFIN-SITU CANCER OF THE UTERINE CERVIX

Retrospective data are analyzed from 217 patients conservatively treat ed for in situ cervical cancer, as diagnosed by colposcopically direct ed biopsies. One hundred twenty-four patients were treated by diatherm y loop (57%), 43 patients were submitted to laser vaporization or diat hermocoagulation (19.9%), and 50 patients (23%) had a surgical cone. T he outpatient treatment never had to be stopped for pain or hemorrhage . After treatment, every patient had a periodic colposcopic and cytolo gic follow-up (mean follow-up 48 months). The cure rates were similar for the three therapy methods (94% overall, 93% diathermy loop, 96% su rgical cone, and 95.4% laser or diathermocoagulation). Relapses were s uccessfully treated, again with conservative therapy. Histologic exami nation of the surgical specimen was always possible for both the diath ermy 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 sig nificant). In 3 cases, a microinvasion was detectable in the specimen, and 1 patient had an associated cervical adenocarcinoma. The diatherm y loop appears to be a reliable therapy for almost all patients with C IN 3.