Korean J Obstet Gynecol.  2005 Nov;48(11):2578-2585.

Conization by combination of loop electrosurgical excision procedure (LEEP) and cold coagulation for the stage Ia1 squamous cell carcinoma of the uterine cervix

• Jung KL
• Lee JW
• Lee HY
• Choi YL
• Ahn GH
• Lee JH
• Kim BG
• Bae DS

Abstract

OBJECTIVE
This study was performed to evaluate the results of conization by loop electrosurgical excision procedure (LEEP) and cold coagulation as a definitive treatment in the patients with FIGO stage Ia1 squamous cell carcinoma of the cervix.
METHODS
One hundred eighty-seven patients were diagnosed as stage Ia1 cervical squamous cell carcinomas from 1995 to 2004 by conization with LEEP and cold coagulation. Fifty-nine patients who wanted to preserve fertility and/or refused further surgical treatment were followed-up without further treatment. Eleven patients of the 59 had involved ectocervical resection margins. All patients were followed-up with cervicovaginal smear and colposcopic examination at a regular interval. Disease recurrence was defined as a histologic diagnosis of dysplasia or more.
RESULTS
The median follow-up period was 69.0 months (range 8 to 103). All 59 patients had no lymphvascular space invasion (LVSI). In four patients, the ectocervical margins were involved by dysplasia, in seven patients, by carcinoma in-situ. There were no specific differences in ages, depth of stromal invasion and HPV status between the groups with and without involved margins. All 59 patients did not recur during follow-up period.
CONCLUSION
Conization with LEEP and cold coagulation was feasible and could be used as a definitive therapy for the patients with stage Ia1 cervical squamous cell carcinoma. This study suggests that conization might play a role in a patient with positive margins (dysplasia or CIS) when LVSI is not demonstrated.

Keyword

Stage Ia1; Conization; LEEP; Cold coagulation; Resection margin

MeSH Terms

Carcinoma, Squamous Cell*
Cervix Uteri*
Conization*
Diagnosis
Female
Fertility
Follow-Up Studies
Humans
Recurrence