The impact of LEEP margin status on subsequent abnormal cervical cytology

Andrea S O'Shea,Colleen K Stockdale

doi:10.17077/2154-4751.1249

Andrea S O'Shea, Colleen K Stockdale

Open Access

https://doi.org/10.17077/2154-4751.1249

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Abstract

Objective: To evaluate the relationship between Loop Electrosurgical Excision Procedure (LEEP) margin status and subsequent cytology results to determine the significance of margin status as a predictor for recurrent cervical disease. Methods: A retrospective cohort of women who underwent LEEP for treatment of cervical dysplasia from 1995 to 2006 with subsequent follow-up to 2009 at a single academic institution. Data extracted consisted of information routinely collected during clinic visits including demographic information, LEEP histology results, and cytology results. Results: The analysis was limited to 144 women with documented LEEP margin status and subsequent cytologic follow-up. The women were predominantly white, non-Hispanic, with a mean age of 27 years (range 14 – 62 years). Of

Highlights

Over the past two decades, data has emerged regarding the natural history of cervical intraepithelial neoplasia (CIN) in various age groups
The aim of this study was to evaluate the relationship between Loop electrosurgical excision procedure (LEEP) margin status and subsequent cytology results to determine the significance of margin status as a predictor for recurrent cervical disease
All women who underwent a LEEP procedure for cervical dysplasia with known margin status and who had subsequent cytological follow up were eligible for analysis

Summary

Introduction

Over the past two decades, data has emerged regarding the natural history of cervical intraepithelial neoplasia (CIN) in various age groups. Loop electrosurgical excision procedure (LEEP) is a commonly utilized diagnostic and treatment modality for CIN 2,3 because it provides a specimen for histological examination while being safe and effective in the outpatient setting.[2] In select patients, it has the advantage of allowing diagnosis and treatment in a single visit.[2] Treatment is not without risk, . As stated above, increased obstetrical risks following treatment with LEEP include preterm premature rupture of membranes, preterm delivery, and low birth weight.[3,4,5] Such risks highlight the trend for more conservative management of CIN 2 and CIN 2,3 especially in younger populations

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