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Conization
Source: Cervical Cancer Treatment (PDQ®)–Health Professional Version, National Cancer Institute.
Source updated: May 13, 2025 · Captured 2026-09-09.
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Context: Treatment of In Situ Cervical Cancer / Treatment Options for In Situ Cervical Cancer
When the endocervical canal is involved, laser or cold-knife conization may be used for selected patients to preserve the uterus, avoid radiation therapy, and more extensive surgery.[6]
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In selected cases, the outpatient LEEP may be an acceptable alternative to cold-knife conization. This procedure requires only local anesthesia and obviates the risks associated with general anesthesia for cold-knife conization.[7-9] However, controversy exists about the adequacy of LEEP as a replacement for conization; LEEP is unlikely to be sufficient for patients with adenocarcinoma in situ.[10]
Evidence (conization using LEEP):
A trial comparing LEEP with cold-knife cone biopsy showed no difference in the likelihood of complete excision of dysplasia.[6]
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Two case reports suggested that the use of LEEP in patients with occult invasive cancer led to an inability to accurately determine depth of invasion when a focus of the cancer was transected.[11]
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Preserved source evidence · Not medical advice