Defining the short-term disease recurrence after loop electrosurgical excision procedure (LEEP)

Area of Science:

• Gynecologic Oncology
• Cervical Cancer Screening and Management
• Colposcopy and HPV Testing

Background:

• Cervical cancer screening aims to detect and treat dysplastic lesions to prevent invasive disease.
• Post-treatment surveillance strategies, including colposcopy and Human Papilloma Virus (HPV) testing, vary.
• Loop Electrosurgical Excision Procedure (LEEP) is a common treatment for pre-invasive HPV-mediated cervical disease.

Purpose of the Study:

• To determine the prevalence of high-grade cervical disease (CIN 2/3) at the second follow-up colposcopy visit.
• To evaluate outcomes in a clinical setting that combines LEEP with laser ablation for cervical dysplasia treatment.
• To assess disease recurrence rates following treatment for pre-invasive cervical lesions.

Main Methods:

• Retrospective cohort study of 221 patients treated between January 2010 and December 2015.
• Data extracted from electronic medical records at the Tom Baker Cancer Centre.
• Descriptive and analytic statistics used to analyze patient outcomes and recurrence rates.

Main Results:

• 86% of patients were discharged after the second colposcopy follow-up visit.
• 3.2% of patients (7 out of 221) required further treatment for high-grade disease (CIN 2/3).
• One patient underwent repeat LEEP for persistent low-grade squamous intraepithelial lesion (LSIL).

Conclusions:

• The prevalence of high-grade disease recurrence after LEEP and laser ablation is 3.2%.
• This recurrence rate is comparable to published literature on CIN 2/3 recurrence.
• The findings support current follow-up protocols for patients treated for cervical dysplasia.