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Repeat LEEP conization in patients with cervical intraepithelial neoplasia grade 3 and positive ectocervical margins
Ali Ayhan1, F Kubra Boynukalin, Suleyman Guven
1Department of Obstetrics and Gynecology, Division of Gynecology, Baskent University, School of Medicine, Ankara, Turkey.
Objective:
To evaluate the effectiveness of repeat loop electrosurgical excision procedure (LEEP) conization in patients with cervical intraepithelial neoplasia (CIN) grade 3 and positive ectocervical margins.
Method:
A retrospective study of 56 women who underwent repeat LEEP conization for CIN 3 and positive ectocervical margins.
Results:
Final diagnosis after repeat LEEP conization revealed 6 women (10.7%) with microinvasive squamous cell carcinoma (Stage IA1); 1 (1.8%) with CIN 1; 1 (1.8%) with CIN 2; 21 (37.5%) with CIN 3; and 27 (48.2%) with chronic cervicitis. Ectocervical or endocervical margins were negative after repeat LEEP conization in the majority of women, except for 2 patients (3.6%) with CIN 3 and positive ectocervical margins. Recurrence rate for the median follow-up time of 2 years was 6.1% (3 patients).
Conclusion:
Repeat LEEP conization can reveal undiagnosed microinvasive cervical carcinoma in women with positive ectocervical margins.