Publication: Long-term outcomes of a loop electrosurgical excision procedure for cervical intraepithelial neoplasia in a high incidence country
Issued Date
2014-01-01
Resource Type
ISSN
2476762X
15137368
15137368
Other identifier(s)
2-s2.0-84894653443
Rights
Mahidol University
Rights Holder(s)
SCOPUS
Bibliographic Citation
Asian Pacific Journal of Cancer Prevention. Vol.15, No.2 (2014), 1035-1039
Suggested Citation
Suthi Sangkarat, Irene Ruengkhachorn, Mongkol Benjapibal, Somsak Laiwejpithaya, Weerasak Wongthiraporn, Manee Rattanachaiyanont Long-term outcomes of a loop electrosurgical excision procedure for cervical intraepithelial neoplasia in a high incidence country. Asian Pacific Journal of Cancer Prevention. Vol.15, No.2 (2014), 1035-1039. doi:10.7314/APJCP.2014.15.2.1035 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/33379
Research Projects
Organizational Units
Authors
Journal Issue
Thesis
Title
Long-term outcomes of a loop electrosurgical excision procedure for cervical intraepithelial neoplasia in a high incidence country
Other Contributor(s)
Abstract
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±10.5 years. The histopathology of LEEP specimens revealed that 89 patients (21.9%) had lesions ≤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.