Efficacy of loop electrosurgical excision procedure with cold coagulation for treating cervical intraepithelial neoplasia: A two center cohort study.
10.5468/ogs.2017.60.2.200
- Author:
Hee Seung KIM
1
;
Jeong Eun KWON
;
Jeong Ha KIM
;
Anna KIM
;
Na Ra LEE
;
Miseon KIM
;
Maria LEE
;
Dong Hoon SUH
;
Yong Beom KIM
Author Information
1. Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea.
- Publication Type:Original Article
- Keywords:
Cervical intraepithelial neoplasia;
Cold coagulation;
Loop electrosurgical excisional procedure
- MeSH:
Cervical Intraepithelial Neoplasia*;
Cohort Studies*;
Humans;
Papanicolaou Test;
Recurrence
- From:Obstetrics & Gynecology Science
2017;60(2):200-206
- CountryRepublic of Korea
- Language:English
-
Abstract:
OBJECTIVE: To evaluate the efficacy of loop electrosurgical excision procedure (LEEP) combined with cold coagulation for treating cervical intraepithelial neoplasia (CIN). METHODS: We reviewed clinic-pathologic data of 498 patients treated with LEEP alone (n=354), and LEEP combined with cold coagulation (n=144) between January 2000 and December 2011. After LEEP, we followed up all patients by using Papanicolaou smear and human papillomavirus (HPV) test, and evaluated abnormal cervical cytology-free interval and high-risk HPV infection-free interval. Moreover, we investigated independent factors affecting abnormal cervical cytology or high-risk HPV infection after LEEP. RESULTS: Abnormal cervical cytology-free interval was longer in patients treated with LEEP combined with cold coagulation than in those treated with LEEP alone (mean, 92.4 vs. 84.4 months; P=0.01), and patients treated with LEEP combined with cold coagulation also showed longer high-risk HPV infection-free interval than those treated with LEEP alone (mean, 87.6 vs. 59.1 months; P=0.01). Moreover, CIN 3 and cold coagulation were factors affecting abnormal cervical cytology after LEEP (adjusted hazard ratios, 1.90 and 0.61; 95% confidence intervals, 1.27 to 2.84 and 0.39 to 0.96), and CIN 3, positive deep cervical margin and cold coagulation were also factors affecting high-risk HPV infection after LEEP (adjusted hazard ratios, 2.07, 4.11, and 0.64; 95% confidence intervals, 1.38 to 3.08, 1.63 to 10.39, and 0.43 to 0.96). When we performed subgroup analyses for patients with CIN 2 or CIN 3, the result were similar. CONCLUSION: LEEP combined with cold coagulation may be more effective for treating CIN than LEEP alone. Moreover, cold coagulation may decrease the risk of potential of recurrence after LEEP.
