Recurrence rate after loop electrosurgical excision procedure (LEEP) and laser Conization: A 5-year follow-up study

Bogani, Giorgio; Donato, Violante Di; Sopracordevole, Francesco; Ciavattini, Andrea; Ghelardi, Alessandro; Lopez, Salvatore; Simoncini, Tommaso; Plotti, Francesco; Casarin, Jvan; Serati, Maurizio; Pinelli, Ciro; Valenti, Gaetano; Bergamini, Alice; Gardella, Barbara; Dell’Acqua, A.; Monti, Ermelinda; Vercellini, Paolo; Fischetti, Margherita; D’Ippolito, Giovanni; Aguzzoli, Lorenzo; Mandato, Vincenzo Dario; Carunchio, Paola; Carlinfante, Gabriele; Giannella, Luca; Scaffa, Cono; Falcone, Francesca; Borghi, Chiara; Ditto, Antonino; Malzoni, Mario; Giannini, Andrea; Salerno, Maria Giovanna; Liberale, Viola; Contino, Biagio; Donfrancesco, Cristina; Desiato, Michele; Perrone, Anna Myriam; Dondi, Giulia; Iaco, Pierandrea De; Maggiore, Umberto Leone Roberti; Signorelli, Mauro; Chiappa, Valentina; Ferrero, Simone; Sarpietro, Giuseppe; Matarazzo, Maria Grazia; Cianci, Antonio; Bosio, Sara; Ruisi, Simona; Guerrisi, Rocco; Brusadelli, Claudia; Mosca, Lavinia; Tinelli, Raffaele; Vincenzo, Rosa De; Zannoni, Gian Franco; Ferrandina, Gabriella; Petrillo, Marco; Dessole, Salvatore; Angioli, Roberto; Greggi, Stefano; Spinillo, Arsenio; Ghezzi, Fabio; Colacurci, Nicola; Muzii, Ludovico; Panici, Pierluigi Benedetti; Scambia, Giovanni; Raspagliesi, Francesco

doi:10.1016/j.ygyno.2020.08.025

Cited by 82 publications

(66 citation statements)

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“…A chart of consecutive patients with newly diagnosed high-grade cervical dysplasia (HSIL) treated in Italy from 1 January 2010 to 31 December 2014 was collected. The present paper is a secondary analysis of research that aimed to identify prognostic factors for developing HSIL recurrence after primary conization and to assess the risk of recurrence based on surgical techniques (laser conization vs. loop electrosurgical excision procedure (LEEP)) [ 11 ]. Details of this study are reported elsewhere [ 11 ].…”

Section: Methodsmentioning

confidence: 99%

“…A secondary endpoint measure was to evaluate a possible risk factor for HSIL recurrence in women having HPV vaccination after conization. To avoid possible confounding factors, we just focused on patients undergoing conization with LEEP [ 11 ].…”

Section: Methodsmentioning

confidence: 99%

“…Patients were treated on an outpatient basis using local anesthesia. Procedures were performed under colposcopic guidance, using the LEEP technique [ 11 ]. The surgical technique is standardized.…”

Section: Methodsmentioning

confidence: 99%

“…The surgical technique is standardized. Details about surgical treatment are reported elsewhere [ 11 , 12 , 13 ].…”

Section: Methodsmentioning

confidence: 99%

“…HPV types were considered high-risk according to the International Agency for Research on Cancer (IARC) [ 14 ]. Details of the type of procedures executed, clinical examination, and follow-up were reported elsewhere [ 11 ]. Persistent/recurrent cervical dysplasia was defined as the diagnosis of a new HSIL requiring secondary conization or more radical treatments (e.g., hysterectomy).…”

Section: Methodsmentioning

confidence: 99%

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Assessing the Long-Term Role of Vaccination against HPV after Loop Electrosurgical Excision Procedure (LEEP): A Propensity-Score Matched Comparison

et al. 2020

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Background: Primary prevention through vaccination is a prophylactic approach aiming to reduce the risk of developing human papillomavirus (HPV)-related lesions. No mature and long-term data supported the adoption of vaccination in women undergoing conization. Methods: This is a retrospective multi-institutional study. Charts of consecutive patients undergoing conization between 2010 and 2014 were collected. All patients included had at least 5 years of follow-up. We compared outcomes of patients undergoing conization plus vaccination and conization alone. A propensity-score matching algorithm was applied in order to reduce allocation biases. The risk of developing recurrence was estimated using Kaplan-Meir and Cox hazard models. Results: Overall, charts of 1914 women were analyzed. The study group included 116 (6.1%) and 1798 (93.9%) women undergoing conization plus vaccination and conization alone, respectively. Five-year recurrence rate was 1.7% (n = 2) and 5.7% (n = 102) after conization plus vaccination and conization alone, respectively (p = 0.068). After the application of a propensity-score matching, we selected 100 patients undergoing conization plus vaccination and 200 patients undergoing conization alone. The crude number of recurrences was 2 (2%) and 11 (5.5%) for patients undergoing conization plus vaccination and conization alone, respectively (p = 0.231). Vaccination had no impact on persistent lesions (no negative examination between conization and new cervical dysplasia; p = 0.603), but reduced the risk of recurrent disease (patients who had at least one negative examination between conization and the diagnosis of recurrent cervical dysplasia; p = 0.031). Conclusions: Patients having vaccination experience a slightly lower risk of recurrence than women who had not, although not statistically significantly different. Further evidence is needed to assess the cost effectiveness of adopting vaccination in this setting.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

“…The surgical technique is standardized. Details about surgical treatment are reported elsewhere [ 11 , 12 , 13 ].…”

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Assessing the Long-Term Role of Vaccination against HPV after Loop Electrosurgical Excision Procedure (LEEP): A Propensity-Score Matched Comparison

et al. 2020

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Application of EfficientNet‐B0 and GRU‐based deep learning on classifying the colposcopy diagnosis of precancerous cervical lesions

Chen

et al. 2023

Cancer Medicine

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Background: Colposcopy is indispensable for the diagnosis of cervical lesions.However, its diagnosis accuracy for high-grade squamous intraepithelial lesion (HSIL) is at about 50%, and the accuracy is largely dependent on the skill and experience of colposcopists. The advancement in computational power made it possible for the application of artificial intelligence (AI) to clinical problems. Here, we explored the feasibility and accuracy of the application of AI on precancerous and cancerous cervical colposcopic image recognition and classification. Methods:The images were collected from 6002 colposcopy examinations of normal control, low-grade squamous intraepithelial lesion (LSIL), and HSIL. For each patient, the original, Schiller test, and acetic-acid images were all collected.We built a new neural network classification model based on the hybrid algorithm. EfficientNet-b0 was used as the backbone network for the image feature extraction, and GRU(Gate Recurrent Unit)was applied for feature fusion of the three modes examinations (original, acetic acid, and Schiller test). Results:The connected network classifier achieved an accuracy of 90.61% in distinguishing HSIL from normal and LSIL. Furthermore, the model was applied to "Trichotomy", which reached an accuracy of 91.18% in distinguishing the HSIL, LSIL and normal control at the same time. Conclusion:Our results revealed that as shown by the high accuracy of AI in the classification of colposcopic images, AI exhibited great potential to be an effective tool for the accurate diagnosis of cervical disease and for early therapeutic intervention in cervical precancer.

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Burden of CIN2+ diagnoses and conizations in women aged 18–45 years—a retrospective secondary data analysis of German statutory health insurance claims data

Reuschenbach

Stephan

Saxena³

et al. 2022

Arch Gynecol Obstet

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Purpose High grade cervical intraepithelial neoplasia (CIN2+) may progress to cervical cancer. They may be detected by screening and are usually treated by conization. This study aimed at assessing annual proportions of screening, prevalent and incident CIN2+ diagnoses, as well as proportions of (re-)conizations during 24 months follow-up after conization in Germany. Methods A descriptive retrospective claims data analysis of the years 2013–2018 was conducted using the InGef Research Database. Women aged 18–45 years with CIN2+ diagnoses were identified by ICD-10-GM codes (N87.1, N87.2, D06.-, and C53.-). Cervical conizations were identified by OPS codes (5–671.0* or 5–671.1*). Screening participation was identified by EBM codes (01730, 01733, 32819 or 32820). Annual proportions were calculated as women with the respective documented codes divided by all women in the respective age group per calendar year. Results Overall annual proportions of screened women spanned from 60.01 to 61.33% between 2013 and 2018. The overall annual prevalence of CIN2+ diagnoses (regardless of screening participation) ranged from 0.72 to 0.84% between 2013 and 2018, with highest proportions observed in women aged 27–45 years. Also, CIN2+ incidence was highest in women 27–45 years. Annual proportion of women undergoing conization was 0.24% in 2013 and 0.21% in 2018. During a 24-month follow-up period after conization, 2.91% of women underwent a re-conization 3 months or later after the initial conization. Conclusion This analysis demonstrates a considerable burden of CIN2+, conizations and re-conizations in Germany, especially in women aged 27–45 years. This highlights the need for intensified prevention efforts such as expanding human papillomavirus (HPV) vaccination.

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Recurrence rate after loop electrosurgical excision procedure (LEEP) and laser Conization: A 5-year follow-up study

Cited by 82 publications

References 17 publications

Assessing the Long-Term Role of Vaccination against HPV after Loop Electrosurgical Excision Procedure (LEEP): A Propensity-Score Matched Comparison

Assessing the Long-Term Role of Vaccination against HPV after Loop Electrosurgical Excision Procedure (LEEP): A Propensity-Score Matched Comparison

Application of EfficientNet‐B0 and GRU‐based deep learning on classifying the colposcopy diagnosis of precancerous cervical lesions

Burden of CIN2+ diagnoses and conizations in women aged 18–45 years—a retrospective secondary data analysis of German statutory health insurance claims data

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