Annals of Diagnostic Pathology
Volume 12, Issue 1 , Pages 17-20 , February 2008

Significance of disease extent in high-grade cervical intraepithelial neoplasia excised with negative margins by loop electrosurgical excision procedure

  • Oluwole Fadare, MD

      Affiliations

    • Department of Pathology, Wilford Hall Medical Center, Lackland AFB, TX 78236, USA
    • Department of Pathology, University of Texas Health Science Center at San Antonio, San Antonio, TX 78229, USA
    • Corresponding Author InformationCorresponding author. Department of Pathology, Wilford Hall Medical Center, Lackland AFB, TX 78236, USA. Tel.: +1 210 2923361; fax: +1 210 2927484.
    • ,
  • Gabriella Cardoza-Favarato, MD

      Affiliations

    • Department of Pathology, Wilford Hall Medical Center, Lackland AFB, TX 78236, USA
    • Pathology Program, San Antonio Uniformed Services Health Education Consortium, San Antonio, TX 78236, USA

References 

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  3. Cirisano FD. Management of pre-invasive disease of the cervix. Semin Surg Oncol. 1999;16:222–227
  4. Cox JT. Management of cervical intraepithelial neoplasia. Lancet. 1999;353:857–859
  5. Dodson MK, Sharp HT. Uses and abuses of the loop electrosurgical excision procedure (LEEP). Clin Obstet Gynecol. 1999;42:916–921
  6. Soutter WP, de Barros Lopes A, Fletcher A, Monaghan JM, Duncan ID, Paraskevaidis E, et al. Invasive cervical cancer after conservative therapy for cervical intraepithelial neoplasia. Lancet. 1997;349:978–980
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  9. Sankasem A, Thavaramara T, Manusirivithaya S, Tangjitgamol S. Tumor persistence in high grade squamous intraepithelial lesion patients with positive surgical margin post loop electrosurgical excision procedure. J Med Assoc Thai. 2006;89:934–940
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  11. Felix JC, Muderspach LI, Duggan BD, Roman LD. The significance of positive margins in loop electrosurgical cone biopsies. Obstet Gynecol. 1994;84:996–1000
  12. Zaitoun AM, McKee G, Coppen MJ, Thomas SM, Wilson PO. Completeness of excision and follow up cytology in patients treated with loop excision biopsy. J Clin Pathol. 2000;53:191–196
  13. Gardeil F, Barry-Walsh C, Prendiville W, Clinch J, Turner MJ. Persistent intraepithelial neoplasia after excision for cervical intraepithelial neoplasia grade III. Obstet Gynecol. 1997;89:419–422
  14. Gonzalez DI, Zahn CM, Retzloff MG, Moore WF, Kost ER, Snyder RR. Recurrence of dysplasia after loop electrosurgical excision procedures with long-term follow-up. Am J Obstet Gynecol. 2001;184:315–321
  15. Livasy CA, Maygarden SJ, Rajaratnam CT, Novotny DB. Predictors of recurrent dysplasia after a cervical loop electrocautery excision procedure for CIN-3: a study of margin, endocervical gland, and quadrant involvement. Mod Pathol. 1999;12:233–238
  16. Hulman G, Pickles CJ, Gie CA, Dowling FM, Stocks PJ, Dixon R. Frequency of cervical intraepithelial neoplasia following large loop excision of the transformation zone. J Clin Pathol. 1998;51:375–377
  17. Kalogirou D, Antoniou G, Karakitsos P, Botsis D, Kalogirou O, Giannikos L. Predictive factors used to justify hysterectomy after loop conization: increasing age and severity of disease. Eur J Gynaecol Oncol. 1997;18:113–116
  18. Hanau CA, Bibbo M. The case for cytologic follow-up after LEEP. Acta Cytol. 1997;41:731–736
  19. Fan Q, Tay SK, Shen K. Loop electrosurgical excision procedure: a valuable method for the treatment of cervical intraepithelial neoplasia. Zhonghua Fu Chan Ke Za Zhi. 2001;36:271–274[In Chinese]
  20. Zlatkov V, Mikhova A, Kostova P. Our experience with the LEEP/LLETZ technique in the diagnostics and treatment of the precancer lesions of the uterine cervix. Akush Ginekol (Sofia). 2004;43(Suppl 4):55–58[In Bulgarian]
  21. Murdoch JB, Morgan PR, Lopes A, Monaghan JM. Histological incomplete excision of CIN after large loop excision of the transformation zone (LLETZ) merits careful follow up, not retreatment. Br J Obstet Gynaecol. 1992;99:990–993
  22. Flannelly G, Bolger B, Fawzi H, De Lopes AB, Monaghan JM. Follow up after LLETZ: could schedules be modified according to risk of recurrence?. BJOG. 2001;108:1025–1030
  23. de Cabezon RH, Sala CV, Gomis SS, Lliso AR, Bellvert CG. Evaluation of cervical dysplasia treatment by large loop excision of the transformation zone (LLETZ). Does completeness of excision determine outcome?. Eur J Obstet Gynecol Reprod Biol. 1998;78:83–89
  24. Lu CH, Liu FS, Kuo CJ, Chang CC, Ho ES. Prediction of persistence or recurrence after conization for cervical intraepithelial neoplasia III. Obstet Gynecol. 2006;107:830–835
  25. Lu CH, Liu FS, Tseng JJ, Ho ES. Predictive factors for residual disease in subsequent hysterectomy following conization for CIN III. Gynecol Oncol. 2000;79:284–288
  26. Cardoza-Favarato G, Fadare O. High grade squamous intraepithelial lesion excised with negative margins by loop electrosurgical excision procedure: the significance of CIN 1 at the margins of excision. Hum Pathol. 2007;38:781–786
  27. Solomon D, Davey D, Kurman R, Moriarty A, O'Connor D, Prey M, et al. Forum Group Members; Bethesda 2001 Workshop. The 2001 Bethesda System: terminology for reporting results of cervical cytology. JAMA. 2002;287:2114–2119

☆ The opinions and/or assertions contained herein are solely those of the authors and should not be construed as official, or as representing the views of the US Government or any of its subsidiaries.

PII: S1092-9134(07)00018-4

doi: 10.1016/j.anndiagpath.2007.01.012

Annals of Diagnostic Pathology
Volume 12, Issue 1 , Pages 17-20 , February 2008

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