Long-term Outcomes of a Loop Electrosurgical Excision Procedure for Cervical Intraepithelial Neoplasia in a High Incidence Country

Sangkarat, Suthi; Ruengkhachorn, Irene; Benjapibal, Mongkol; Laiwejpithaya, Somsak; Wongthiraporn, Weerasak; Rattanachaiyanont, Manee

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자료유형: 학술저널

저자정보: Sangkarat, Suthi (Department of Obstetrics and Gynecology, Faculty of Medicine Siriraj Hospital, Mahidol University) Ruengkhachorn, Irene (Gynecologic Oncology Division, Faculty of Medicine Siriraj Hospital, Mahidol University) Benjapibal, Mongkol (Gynecologic Oncology Division, Faculty of Medicine Siriraj Hospital, Mahidol University) Laiwejpithaya, Somsak (Gynecologic Cytology Unit, Faculty of Medicine Siriraj Hospital, Mahidol University) Wongthiraporn, Weerasak (Department of Obstetrics and Gynecology, Faculty of Medicine Siriraj Hospital, Mahidol University) Rattanachaiyanont, Manee (Gynecologic Endocrinology Unit, Faculty of Medicine Siriraj Hospital, Mahidol University)

저널정보: 아시아태평양암예방학회 Asian Pacific journal of cancer prevention : APJCP Asian Pacific journal of cancer prevention : APJCP 제15권 제2호

발행연도: 2014.1

수록면: 1,035 - 1,039 (5page)

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Aim: To evaluate the operative, oncologic and obstetric outcomes of the loop electrosurgical excision procedure (LEEP) in cases with cervical neoplasia. Materials and Methods: A retrospective cohort study was conducted on patients who were suspected of cervical neoplasia and therefore undergoing LEEP at Siriraj Hospital, Mahidol University, Thailand, during 1995-2000. Outcome measures included operative complications in 407 LEEP patients and long-term outcomes in the 248 patients with cervical intraepithelial neoplasia (CIN) who were treated with only LEEP. Results: There were 407 patients undergoing LEEP; their mean age was $39.7{\pm}10.5$ years. The histopathology of LEEP specimens revealed that 89 patients (21.9%) had lesions ${\leq}CIN$ I, 295 patients (72.5%) had CIN II or III, and 23 patients (5.6%) had invasive lesions. Operative complications were found in 15 patients and included bleeding (n=9), and infection (n=7). After diagnostic LEEP, 133 patients underwent hysterectomy as the definite treatment for cervical neoplasia. Of 248 CIN patients who had LEEP only, seven (2.8%) had suffered recurrence after a median of 16 (range 6-93) months; one had CIN I, one had CIN II, and five had CIN III. All of these recurrent patients achieved remission on surgical treatment with re-LEEP (n=6) or simple hysterectomy (n=1). A significant factor affecting recurrent disease was the LEEP margin involved with the lesion (p=0.05). Kaplan-Meier analysis showed 5-year and 10-year disease-free survival (DFS) estimates of 99.9%. Twelve patients became pregnant a total of 14 times, resulting in 12 term deliveries and two miscarriages - one of which was due to an incompetent cervix. Conclusions: LEEP for patients with cervical neoplasia delivers favorable surgical, oncologic and obstetric outcomes.

#Cervical neoplasia #loop electrosurgical excision procedure #outcomes #Thailand

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