Significance of disease extent in high-grade cervical intraepithelial neoplasia excised with negative margins by loop electrosurgical excision procedure

Predictors of recurrent/residual disease after loop electrosurgical excisional procedure

“…However, while most ECC‐positive patients underwent a second surgery, most patients with ectocervical margin involvement did not and subsequently improved with no further treatment. Furthermore, the postoperative cytologic abnormality rate in the present study was relatively low, as previous studies have reported that this rate ranges from 3.3% to 33.3% . Unfortunately, the interpretation of this discrepancy is not simple, as it is likely that residual disease may be easily destroyed via ball coagulation diathermy and repair processes when LEEP margins are involved .…”

“…Furthermore, the postoperative cytologic abnormality rate in the present study was relatively low, as previous studies have reported that this rate ranges from 3.3% to 33.3%. [19][20][21][22] Unfortunately, the interpretation of this discrepancy is not simple, as it is likely that residual disease may be easily destroyed via ball coagulation diathermy and repair processes when LEEP margins are involved. 23 In addition, as high-grade squamous intraepithelial lesions are more likely to involve the endocervical canal, ectocervical margin involvement has little clinical value.…”

Endocervical glandular involvement, multicentricity, and extent of the disease are features of high-grade cervical intraepithelial neoplasia

“…Previously, Fadare et al [7] reported that the extent of lesions was not an important factor for recurrence when surgical margins were negative. In contrast, other studies reported higher recurrence rates as the number of involved quadrants increased [8,13,14].…”

“…We evaluated reports of LEEP specimens for the grade, endocervical glandular involvement, multicentricity, positive surgical margins, and percentage of specimen occupied by the lesion. The last criterion was determined according to data from a previously reported study by calculating the proportion of processed slides on which CIN could be identified [7], and patients were divided into 3 groups (b33%, 33%-66%, and N66%). It was not possible to evaluate the surgical margins because of cauterization artifacts in 7 patients; it was not possible to evaluate disease extent in 4 patients and multicentricity in 1 patient because of multiple specimens.…”

Diagnostic and therapeutic cold knife conization for cervical intraepithelial neoplasia

“…Because cold knife conization is performed under general anesthesia, and because of the risk of some complications, the traditional surgical technique has been recently replaced by laser conization and LEEP in many Western countries [5][6][7] . Although these methods can provide histologic information including the depth of invasion and the involvement of the surgical margins, several randomized trials have demonstrated that there were no statistically signifi cant differences in cure rates for CIN among these methods [4,8,9] .…”