Histological incomplete excision of CIN after large loop excision of the transformation zone (LLETZ) merits careful follow up, not retreatment

To quantify and analyse the influence of a histological report of incomplete excision of CIN after LLETZ on frequency of detection of residual CIN. Review of a computerised database of sequential women treated by LLETZ. Initial follow-up was three months post-treatment. The Colposcopy Clinic, Region...

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Bibliographic Details
Published in:British journal of obstetrics and gynaecology Vol. 99; no. 12; p. 990
Main Authors: Murdoch, J B, Morgan, P R, Lopes, A, Monaghan, J M
Format: Journal Article
Language:English
Published: England 01.12.1992
Subjects:
Carcinoma in Situ - pathology
Carcinoma in Situ - surgery
Cervix Uteri - pathology
Clinical Protocols
Colposcopy - methods
Decision Making
Electrocoagulation - methods
Female
Humans
Uterine Cervical Neoplasms - pathology
Uterine Cervical Neoplasms - surgery
ISSN:0306-5456
Online Access:Get more information
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Summary:To quantify and analyse the influence of a histological report of incomplete excision of CIN after LLETZ on frequency of detection of residual CIN. Review of a computerised database of sequential women treated by LLETZ. Initial follow-up was three months post-treatment. The Colposcopy Clinic, Regional Department of Gynaecological Oncology, Queen Elizabeth Hospital, Gateshead, Tyne and Wear, UK. 721 women with CIN diagnosed histologically on LLETZ specimens. In spite of a first time treatment success rate of 95% at 3 months, only 56% of the women were reported to have complete histological excision of CIN. A report suggesting incomplete excision was more likely with more severe CIN, extensive lesions and involvement of the endocervical canal. Furthermore, 21% with residual CIN had apparent complete excision of CIN at LLETZ. A histological report of incomplete excision of CIN at LLETZ does not equate with residual disease. The high treatment success rate of LLETZ means that a report of incomplete excision should stimulate close colposcopic and cytologic follow-up to identify the small number of women with residual CIN after therapy.
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ISSN:0306-5456
DOI:10.1111/j.1471-0528.1992.tb13704.x