Loop electrosurgical excision procedure combined with cold coagulation for cervical intraepithelial neoplasia and adenocarcinoma in-situ: A feasible treatment with a low risk of residual/recurrent disease
Objective This study was performed to evaluate the significance of positive resection margins (RMs) with the loop electrosurgical excision procedure combined with cold coagulation (LEEP with CC) as a definitive treatment for patients with cervical intraepithelial neoplasia (CIN) and adenocarcinoma in-situ .
Methods We retrospectively reviewed 467 patients who underwent LEEP with CC. A right-angled triangular loop in a single pass followed by a CC (120°C) to the cone bed for 10 to 20 seconds was used. Pathology reports and clinical data were obtained and evaluated.
Results Histopathology evaluation of LEEP tissue samples revealed the presence of CIN 1 in 69, CIN 2/3 in 366, AIS in 5 and invasive carcinoma in 16 (microinvasive squamous cell carcinoma (SCC) and invasive SCC, 13 and 3) patients. Margins were positive in 66 (14.5%) cases: 0 in CIN 1, 54 in CIN 2/3 (12.4%), 1 in AIS (20.0%) and 11 in microinvasive/invasive SCC (68.8%). Although 54 CIN2/3 patients with positive RMs did not undergo additional treatment, 1 of these (1.9%) was confirmed to have residual CIN3 at the first follow-up. Two of 8 (25.0%) microinvasive SCC patients with positive RMs were confirmed to have residual diseases (1 microinvasive SCC and 1 invasive SCC) after hysterectomy. Four out of 360 (1 positive RM, 3 negative RM) CIN cases recurred during the study period.
Conclusions These results suggest that CIN patients with positive RMs after LEEP with CC may be followed up without additional treatment.
Posted 22 Sep, 2020
On 06 Oct, 2020
On 22 Sep, 2020
On 22 Sep, 2020
On 21 Sep, 2020
On 21 Sep, 2020
On 10 Sep, 2020
Received 09 Sep, 2020
Received 02 Sep, 2020
On 29 Aug, 2020
Received 27 Aug, 2020
On 26 Aug, 2020
On 25 Aug, 2020
Invitations sent on 21 Aug, 2020
On 03 Aug, 2020
On 02 Aug, 2020
On 02 Aug, 2020
On 31 Jul, 2020
Loop electrosurgical excision procedure combined with cold coagulation for cervical intraepithelial neoplasia and adenocarcinoma in-situ: A feasible treatment with a low risk of residual/recurrent disease
Posted 22 Sep, 2020
On 06 Oct, 2020
On 22 Sep, 2020
On 22 Sep, 2020
On 21 Sep, 2020
On 21 Sep, 2020
On 10 Sep, 2020
Received 09 Sep, 2020
Received 02 Sep, 2020
On 29 Aug, 2020
Received 27 Aug, 2020
On 26 Aug, 2020
On 25 Aug, 2020
Invitations sent on 21 Aug, 2020
On 03 Aug, 2020
On 02 Aug, 2020
On 02 Aug, 2020
On 31 Jul, 2020
Objective This study was performed to evaluate the significance of positive resection margins (RMs) with the loop electrosurgical excision procedure combined with cold coagulation (LEEP with CC) as a definitive treatment for patients with cervical intraepithelial neoplasia (CIN) and adenocarcinoma in-situ .
Methods We retrospectively reviewed 467 patients who underwent LEEP with CC. A right-angled triangular loop in a single pass followed by a CC (120°C) to the cone bed for 10 to 20 seconds was used. Pathology reports and clinical data were obtained and evaluated.
Results Histopathology evaluation of LEEP tissue samples revealed the presence of CIN 1 in 69, CIN 2/3 in 366, AIS in 5 and invasive carcinoma in 16 (microinvasive squamous cell carcinoma (SCC) and invasive SCC, 13 and 3) patients. Margins were positive in 66 (14.5%) cases: 0 in CIN 1, 54 in CIN 2/3 (12.4%), 1 in AIS (20.0%) and 11 in microinvasive/invasive SCC (68.8%). Although 54 CIN2/3 patients with positive RMs did not undergo additional treatment, 1 of these (1.9%) was confirmed to have residual CIN3 at the first follow-up. Two of 8 (25.0%) microinvasive SCC patients with positive RMs were confirmed to have residual diseases (1 microinvasive SCC and 1 invasive SCC) after hysterectomy. Four out of 360 (1 positive RM, 3 negative RM) CIN cases recurred during the study period.
Conclusions These results suggest that CIN patients with positive RMs after LEEP with CC may be followed up without additional treatment.