Outcome after treatment of high-grade squamous intraepithelial lesions: relation between colposcopically directed biopsy, conization and cervical loop excision.
OBJECTIVE
The hypothesis that cold-knife conization performed in women with high-grade squamous intraepithelial lesions (HSIL) and unsatisfactory colposcopy is a better procedure than the loop electrosurgical procedure (LEEP) is tested.


METHODS
A retrospective study was conducted in conization specimens of women submitted to LEEP (n = 102) or conization (n = 245) due to HSIL. Age, biopsy, compromised surgical margins in conization, and recurrence were analysed.


RESULTS
The frequency of invasion, non-compromised margins, and recurrence in conization and LEEP were, respectively, 7.7% versus 2.9%, 64.1% versus 48% (p = 0.008), and 33.8% versus 24.1%. Eight (42.1%) and five (26.3%) of 19 women submitted to conization where invasion was found in surgical specimens were, respectively, menopausal or had unsatisfactory colposcopy. Twenty-five (96.2%) of 26 and 23 (95.8%) of 24, respectively, undergoing conization and LEEP had recurrence in the first five years.


CONCLUSIONS
We recommend the use of cold-knife conization in cases where the lesion is located deep in the cervical canal.
Murta
E F C
EF
Discipline of Gynaecology and Obstetrics, Faculty of Medicine of Triângulo Mineiro, Uberaba M.G. (Brazil).
Conti
R
R
Rodovalho
J
J
Barcelos
A C Macêdo
AC
Adad
S J
SJ
de Souza
Hazarabedian
H
D000328:Adult; D001706:Biopsy / Q000379:methods; D001938:Brazil / Q000453:epidemiology; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D003127:Colposcopy / Q000379:methods*; D019092:Conization / Q000379:methods*; D005260:Female; D006801:Humans; D008499:Medical Records; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome; D002583:Uterine Cervical Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D002578:Uterine Cervical Dysplasia / Q000401:mortality / Q000473:pathology / Q000601:surgery*