Loop electrosurgical excision procedure versus expectant management to treat high-grade squamous intraepithelial lesion in women up to 25 years | ||
| The Journal of Genital Surgery | ||
| Article 1, Volume 2018, Articles, February 2022, Pages 1-5 | ||
| Document Type: Original Article | ||
| DOI: 10.21608/jgs.2018.2590.1011 | ||
| Authors | ||
| Dantas Macerly1; Gonçalves Ana2; Mesquita Ada1; Batista Fabiana3; Souza Angélica3; Ricardo N. Cobucci* 4 | ||
| 1Federal University of Rio Grande do Norte-UFRN | ||
| 2Department of Gynecology of Federal University of Rio Grande do Norte-UFRN | ||
| 3Cervical Pathology Department-UFRN | ||
| 4Department of Gynecology and Obstetrics of Potiguar University-UnP | ||
| Abstract | ||
| considerably. Aim: To determine outcome of regression in a cohort of women younger than 25 years old with cervical intraepithelial neoplasia grade 2 and 3 (CIN2/3) undergoing treatment with Loop Electrosurgical Excision Procedure (LEEP) or observational management. Methods: Prospective cohort study was carried out between April 2015 and January 2017 with all newly diagnosed biopsy-proven CIN2/3 outpatients. Analysis was performed that compared women who had immediate surgical treatment with women who chose expectant management. The primary outcome was development of high-grade changes (defined as cytological evidence of atypical squamous cells, cannot exclude high-grade squamous intraepithelial lesion (ASC-H), HSIL, adenocarcinoma in situ, atypical glandular cells (AGC), or worse) from at least one Pap Smear (PS) collected every 6 months in the minimum follow-up of 1 year. Comparisons were made using Cox proportional hazards regression analysis. Results: Sixty-four women were diagnosed through cervical biopsy with CIN 2/3 and could choose between conservative or surgical treatment. In the group up to 19 years of age, 6 (37.5%) with CIN2 chose the expectant management and 10 (62.5%) LEEP. While among 20-25-year-old women, 38 (79.2%) chose surgery and 10 (20.8%), being just 4 with CIN3, chose only follow-up for 1 year. The risk of cytological high-grade abnormality over the follow-up period was 62.5% for expectant management and 4.2% for LEEP group (p=0.001). Conclusion: Women aged up to 25 years with CIN2/3 undergoing treatment with LEEP had a significantly lower risk of cytological high-grade abnormality at 12 months follow-up compared with those who remained only under clinical observation. | ||
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