Assessment of Outcome after LLETZ in Cervical Cancer Prevention

The aim of the present retrospective study was to assess the recurrence rate of preinvasive disease and the newly detected invasive disease rate in a cohort of women treated with excisional methods for high-grade cervical intraepithelial neoplasia (CIN). Women were treated with large loop excision of the transformation zone (LLETZ). Surgical specimens underwent histological examination and the status of endocervical as well as ectocervical margins was recorded. Follow-up protocol included testing for HP HPV DNA at 6 months after the initial treatment following which the patients either went to normal recall if tests were normal, had annual smears or repeat LLETZ if clinically indicated. Majority [54.5 %] patients had negative TOC after LLETZ. In TOC positive patients, colposcopy was normal in 67.8 % patients, low grade and HPV were seen in 14.28 % patients each. No moderate or high grade seen. Colposcopy was normal in 75 % of patients in TOC negative group.78.9 % patients were able to go for normal recall with their GP. Only 6.2 % were advised annual smears. Among the 8 patients taken up for a biopsy, 3 turned out negative, 3 had HPV and only 2 showed CIN 1 changes. NO patient had cervical changes CIN2 or above. NONE of the patients needed a repeat LLETZ. Women having undergone excisional treatment for high-grade CIN indicate a very low risk for recurrent disease and potentially negligible risk for invasive cancer, provided that a strict and vigorous follow-up is offered after treatment.