Long-term cytological and histological outcomes in women managed with loop excision treatment under local anaesthetic for high-grade cervical intraepithelial neoplasia

Long-term cytological and histological outcomes in women managed with loop excision treatment under local anaesthetic for high-grade cervical intraepithelial neoplasia Objective: This study examines the impact of excision margin status after large loop excision of the transformation zone (LLETZ)...

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Main Authors: Woo, Y.L., Badley, C., Jackson, E., Crawford, R.
Format: Article
Published: 2011
Subjects:
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author Woo, Y.L.
Badley, C.
Jackson, E.
Crawford, R.
author_facet Woo, Y.L.
Badley, C.
Jackson, E.
Crawford, R.
author_sort Woo, Y.L.
collection UM
description Long-term cytological and histological outcomes in women managed with loop excision treatment under local anaesthetic for high-grade cervical intraepithelial neoplasia Objective: This study examines the impact of excision margin status after large loop excision of the transformation zone (LLETZ) under local anaesthetic for high-grade cervical intraepithelial neoplasia (HG-CIN) on the cytological and histological outcomes up to 5 years after treatment. Methods: Prospective cytological and histological data were obtained by examination of the colposcopy database at Addenbrooke's Hospital, Cambridge, UK. All women aged between 19 and 50 years who underwent treatment for HG-CIN by LLETZ under local anaesthetic were included in the study. Patients without follow-up data were excluded from the study. The excision margin status was correlated with the subsequent cytological and histological outcomes. Results: A series of 967 women with CIN2 and CIN3 underwent LLETZ excision under local anaesthetic. Overall, 42% of women had disease present at the excision margin following LLETZ. Women with CIN3 were more likely than those with CIN2 to have an involved excision margin (P < 0.0001). Cytological recurrence was highest at 12 months (16%) and did not correlate with the CIN grade or excision margin status. Histological recurrence/persistence was also highest at 12 months follow-up (15%) and this correlated with grade of CIN and margin status (P < 0.0001). Conclusions: Histological recurrence/persistence correlates with grade of CIN and excision margin status. Management of HG-CIN in an outpatient setting under local anaesthetic is safe, cost effective and yields a favourable long-term outcome.
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spelling um.eprints-21832011-10-10T02:57:14Z http://eprints.um.edu.my/2183/ Long-term cytological and histological outcomes in women managed with loop excision treatment under local anaesthetic for high-grade cervical intraepithelial neoplasia Woo, Y.L. Badley, C. Jackson, E. Crawford, R. R Medicine Long-term cytological and histological outcomes in women managed with loop excision treatment under local anaesthetic for high-grade cervical intraepithelial neoplasia Objective: This study examines the impact of excision margin status after large loop excision of the transformation zone (LLETZ) under local anaesthetic for high-grade cervical intraepithelial neoplasia (HG-CIN) on the cytological and histological outcomes up to 5 years after treatment. Methods: Prospective cytological and histological data were obtained by examination of the colposcopy database at Addenbrooke's Hospital, Cambridge, UK. All women aged between 19 and 50 years who underwent treatment for HG-CIN by LLETZ under local anaesthetic were included in the study. Patients without follow-up data were excluded from the study. The excision margin status was correlated with the subsequent cytological and histological outcomes. Results: A series of 967 women with CIN2 and CIN3 underwent LLETZ excision under local anaesthetic. Overall, 42% of women had disease present at the excision margin following LLETZ. Women with CIN3 were more likely than those with CIN2 to have an involved excision margin (P < 0.0001). Cytological recurrence was highest at 12 months (16%) and did not correlate with the CIN grade or excision margin status. Histological recurrence/persistence was also highest at 12 months follow-up (15%) and this correlated with grade of CIN and margin status (P < 0.0001). Conclusions: Histological recurrence/persistence correlates with grade of CIN and excision margin status. Management of HG-CIN in an outpatient setting under local anaesthetic is safe, cost effective and yields a favourable long-term outcome. 2011 Article PeerReviewed Woo, Y.L. and Badley, C. and Jackson, E. and Crawford, R. (2011) Long-term cytological and histological outcomes in women managed with loop excision treatment under local anaesthetic for high-grade cervical intraepithelial neoplasia. Cytopathology , 22 (5). 334-339 . ISSN 0956-5507, http://apps.webofknowledge.com/full_record.do?product=WOS&search_mode=GeneralSearch&qid=1&SID=W2f8PDi8dP7d4g27Gli&page=2&doc=19&cacheurlFromRightClick=no
spellingShingle R Medicine
Woo, Y.L.
Badley, C.
Jackson, E.
Crawford, R.
Long-term cytological and histological outcomes in women managed with loop excision treatment under local anaesthetic for high-grade cervical intraepithelial neoplasia
title Long-term cytological and histological outcomes in women managed with loop excision treatment under local anaesthetic for high-grade cervical intraepithelial neoplasia
title_full Long-term cytological and histological outcomes in women managed with loop excision treatment under local anaesthetic for high-grade cervical intraepithelial neoplasia
title_fullStr Long-term cytological and histological outcomes in women managed with loop excision treatment under local anaesthetic for high-grade cervical intraepithelial neoplasia
title_full_unstemmed Long-term cytological and histological outcomes in women managed with loop excision treatment under local anaesthetic for high-grade cervical intraepithelial neoplasia
title_short Long-term cytological and histological outcomes in women managed with loop excision treatment under local anaesthetic for high-grade cervical intraepithelial neoplasia
title_sort long term cytological and histological outcomes in women managed with loop excision treatment under local anaesthetic for high grade cervical intraepithelial neoplasia
topic R Medicine
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AT badleyc longtermcytologicalandhistologicaloutcomesinwomenmanagedwithloopexcisiontreatmentunderlocalanaestheticforhighgradecervicalintraepithelialneoplasia
AT jacksone longtermcytologicalandhistologicaloutcomesinwomenmanagedwithloopexcisiontreatmentunderlocalanaestheticforhighgradecervicalintraepithelialneoplasia
AT crawfordr longtermcytologicalandhistologicaloutcomesinwomenmanagedwithloopexcisiontreatmentunderlocalanaestheticforhighgradecervicalintraepithelialneoplasia