ECC at LLETZ-An Exploratory Retrospective Cohort Study

Area of Science:

• Gynecologic Oncology
• Cervical Pathology

Background:

• Evaluating the utility of endocervical curettage (ECC) alongside large loop excision of the transformation zone (LLETZ).
• Assessing the diagnostic value of ECC for detecting precancerous lesions above LLETZ margins.
• Addressing the limited data on ECC's predictive value and accuracy in this context.

Purpose of the Study:

• To determine the distribution of histological findings from ECC performed after LLETZ.
• To evaluate the additional diagnostic information provided by ECC.
• To assess the impact of ECC results on subsequent clinical treatment decisions.

Main Methods:

• Retrospective cohort study of 1121 patients undergoing LLETZ and ECC from 2009-2021.
• Analysis of main outcome parameters: histological diagnosis and specimen adequacy.
• Evaluation of ECC's impact on therapeutic approach and detection of residual disease.

Main Results:

• ECC yielded additional diagnostic information in only 1.7% of cases.
• ECC results influenced subsequent treatment in 0.2% of patients.
• A negative ECC showed a low negative predictive value (43.8%) for residual disease detection.

Conclusions:

• Routine ECC performance at the time of LLETZ is questionable.
• Current guidelines favor HPV testing post-LLETZ for treatment success assessment.
• The added diagnostic yield of ECC does not consistently justify its routine use.