European Journal of Gynaecological Oncology (EJGO) is published by IMR Press from Volume 40 Issue 1 (2019). Previous articles were published by another publisher on a subscription basis, and they are hosted by IMR Press on imrpress.com as a courtesy and upon agreement with S.O.G.
Outcome after treatment of high-grade squamous intraepithelial lesions: Relation between colposcopically directed biopsy, conization and cervical loop excision
Purpose of investigation: 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. l % versus 48% (p = 0.008), and 33.8% versus 24. l %. 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. Twentyfive (96.2%) of 26 and 23 (95.8%) of 24, respectively, undergoing conization and LEEP had recurrence in the first five years. Conclusion: We recommend the use of cold-knife conization in cases where the lesion is located deep in the cervical canal.