Recurrence rate after loop electrosurgical excision procedure (LEEP) and laser Conization: A 5-year follow-up study

Purpose To evaluate the recurrence rate of high-grade CIN treated by loop electrosurgical excision procedure (LEEP) and the optimal follow-up schedule. Method 622 cases of CIN2/3 consecutively treated by LEEP in the Florence screening program, with 66.5 months average follow-up (range, 6–195 months), were evaluated. Recurrence was defined as histological evidence of high-grade CIN. Results The average recurrence rate was 9.1% (52 cases). Recurrence was significantly associated to increasing age (χ2 = 12.73, df = 3, P < 001), CIN grade (10.5 vs 6.1%, χ2 = 3.37, df = 1, P = 0.067), and time interval, with the risk of developing a recurrence highest in the first year (7.4%, 95% confidence interval, 5.3–9.5%.), and rare beyond the third year. Multivariate analysis confirmed a significant independent association of age (particularly over age 40) and CIN grade to the risk of recurrence. Conclusions LEEP is an effective procedure for the treatment of high-grade CIN. Most recurrences after LEEP occur in the first 3 years, and non-recurrent cases at that date may stop intensive follow-up and return to current cytological screening every 3 years.

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Recurrence Rate and Risk Factors for Stone Recurrence after Successful Extracorporeal Shock Wave Lithotripsy: 5-year-follow-up Study

Korean Journal of Urology ◽

10.4111/kju.2007.48.1.49 ◽

2007 ◽

Vol 48 (1) ◽

pp. 49 ◽

Cited By ~ 1

Author(s):

Sung Dae Kim ◽

Won Jae Yang ◽

Jae Yong Chung

Keyword(s):

Risk Factors ◽

Shock Wave ◽

Recurrence Rate ◽

Extracorporeal Shock Wave Lithotripsy ◽

Shock Wave Lithotripsy ◽

Follow Up Study ◽

Stone Recurrence ◽

Extracorporeal Shock Wave

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Early MRI imaging and follow-up study in cerebral amyloid angiopathy

Open Medicine ◽

10.1515/med-2021-0212 ◽

2021 ◽

Vol 16 (1) ◽

pp. 257-263

Author(s):

Shan-chun Zhang ◽

Jian-jun Jia ◽

Heng-li Zhao ◽

Bo Zhou ◽

Wei Wang ◽

...

Keyword(s):

Recurrence Rate ◽

Cerebral Amyloid Angiopathy ◽

Superficial Siderosis ◽

Control Group ◽

Amyloid Angiopathy ◽

Imaging Features ◽

Follow Up Study ◽

Imaging Characteristics ◽

Cerebral Amyloid

Abstract Aim To study the imaging features of leukoaraiosis (LA) and hemorrhage in cerebral amyloid angiopathy (CAA) patients. Methods The earliest MRI images of probable CAA patients and non-CAA patients were collected. The characteristics of LA in the two groups were analyzed. Cerebral micro bleeding (CMB), superficial siderosis (SS), and intracranial hemorrhage (ICH) were recorded in the follow-up study. The space relationship between CMB or SS and ICH was assessed. Results We found that 10/21 (47.6%) patients had occipital prominent LA and 14/21 (66.7%) patients had subcortical punctate LA before the ICH, which was higher than that of the ones in the control group (p = 0.015 and 0.038, respectively). The recurrence rate of ICH was 100% (3/3) in patients with diffuse SS and 36.4% (4/11) in patients without. The recurrence rate of ICH was 60% (3/5) in patients with multiple-lobe CMBs and 44.4% (4/9) in those without. The location of the ICH and CMB was inconsistent. ICH occurred in the ipsilateral cerebral hemisphere of SS in three patients with diffuse SS. Conclusion LA, diffuse SS, and multiple-lobe CMBs are important imaging characteristics of CAA, which may help make early diagnosis and predict the recurrence of ICH.

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Defining the short-term disease recurrence after Loop Electrosurgical Excision Procedure (LEEP)

10.21203/rs.2.13812/v1 ◽

2019 ◽

Author(s):

Nicholas Papalia ◽

Amanda Rohla ◽

Selphee Tang ◽

Jill G. Nation ◽

Gregg Nelson

Keyword(s):

Laser Ablation ◽

Disease Surveillance ◽

Clinical Equipoise ◽

High Grade ◽

Inclusion Criteria ◽

Recurrence Rates ◽

Record System ◽

Loop Electrosurgical Excision ◽

Loop Electrosurgical Excision Procedure

Abstract Purpose: The goal of cervical cancer screening is to identify dysplastic lesions for subsequent excision in order to prevent invasive disease. There is clinical equipoise, on how to best follow women for disease surveillance after treatment with some Canadian provinces exclusively performing colposcopy and some utilizing HPV testing in addition to cervical cytology. Loop Electrosurgical Excision Procedure (LEEP) is used to treat pre-invasive HPV-mediated disease and patients are typically followed for 12 months after disease excision. This study aims to quantify the prevalence of high-grade disease at the time of the second follow-up colposcopy visit, in a practice setting that utilizes laser ablation in addition to LEEP. Methods: In a retrospective cohort study, consecutive patient charts were accessed through the electronic medical record system, ARIA, at the Tom Baker Cancer Centre, in Calgary, Alberta, from January 2010 to December 2015. Data was extracted and a REDCap database was used to compile pertinent information from charts meeting inclusion criteria. Descriptive and analytic statistics were performed. Results: Of the 303 patients identified, 221 patients met inclusion criteria. 86% of these patients met discharge criteria from colposcopy after the second follow up visit. Of the 31 (14%) who were seen in a subsequent visit, 7 (3.2%) underwent further treatment for high-grade disease (CIN 2/3). The remaining 23 (10.6%) had a third – negative – visit, resulting in discharge from colposcopy. Conclusion: In summary, our data demonstrates a prevalence of 3.2% of high-grade disease at the time of a second colposcopic follow up visit after treatment, in a setting which frequently utilizes laser ablation in combination with LEEP, for large lesions. This recurrence rate is consistent with most published literature on recurrence rates of CIN2/3.

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Follow-Up of Patients with Positive Margins after Loop Electrosurgical Excision Procedure

Journal of Lower Genital Tract Disease ◽

10.1097/00128360-199701000-00034 ◽

1997 ◽

Vol 1 (1) ◽

pp. 30

Author(s):

T A Dinh ◽

M Garcia ◽

T V Dinh ◽

E V Hannigan ◽

R B Yandell ◽

...

Keyword(s):

Positive Margins ◽

Loop Electrosurgical Excision ◽

Loop Electrosurgical Excision Procedure

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Persistence of human papillomavirus as a predictor for treatment failure after loop electrosurgical excision procedure

International Journal of Gynecological Cancer ◽

10.1111/j.1525-1438.2007.00945.x ◽

2007 ◽

Vol 17 (6) ◽

pp. 1271-1277 ◽

Cited By ~ 35

Author(s):

J. H. Bae ◽

C. J. Kim ◽

T. C. Park ◽

S. E. Namkoong ◽

J. S. Park

Keyword(s):

Human Papillomavirus ◽

Treatment Failure ◽

Significant Risk ◽

Hpv Infection ◽

Dna Chip ◽

Hpv Dna ◽

Hpv Test ◽

Loop Electrosurgical Excision ◽

Loop Electrosurgical Excision Procedure

We aimed to investigate whether postconization human papillomavirus (HPV) DNA testing can predict treatment failure and improve the accuracy of conventional follow-up in women with high-grade cervical intraepithelial neoplasia (CIN). Between March 2001 and October 2005, 120 patients with confirmed CIN 2 or 3 were treated with loop electrosurgical excision procedure (LEEP) and were enrolled. Six patients were lost to the follow-up. Postconization follow-up was performed at every 3–6 months during the first year and then annually. Specimens were tested for the presence of HPV, using the Hybrid Capture 2 (Digene Co, Gaithersburg, MD) and HPV DNA chip (Mygene Co, Seoul, Korea) test. Persistent HPV infection was defined as persistently (two times or more) positive HPV tests with the same HPV subtype(s) at initial diagnosis. Twenty-two (19.3%) patients showed treatment failure after conization. The only significant risk factor for redevelopment of CIN after conization was persistence of the same HPV subtype (P< 0.0001). And women with recurrent or residual CIN had higher HPV load during the 6-month follow-up postconization. In conclusion, the persistence of the same HPV subtype after LEEP conization was an important predictor of treatment failure. The follow-up protocol after conization of CIN should include both cervical cytology and HPV test, and HPV DNA chip test is needed to detect a persistent HPV infection.

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Defining the short-term disease recurrence after Loop Electrosurgical Excision Procedure (LEEP)

10.21203/rs.2.13812/v3 ◽

2020 ◽

Author(s):

Nicholas Papalia ◽

Amanda Rohla ◽

Selphee Tang ◽

Jill G. Nation ◽

Gregg Nelson

Keyword(s):

Laser Ablation ◽

Disease Surveillance ◽

Clinical Equipoise ◽

High Grade ◽

Inclusion Criteria ◽

Recurrence Rates ◽

Record System ◽

Loop Electrosurgical Excision ◽

Loop Electrosurgical Excision Procedure

Abstract Background The goal of cervical cancer screening is to identify dysplastic lesions for subsequent excision in order to prevent invasive disease. There is clinical equipoise, on how to best follow women for disease surveillance after treatment with some Canadian provinces exclusively performing colposcopy and some utilizing HPV testing in addition to cervical cytology. Loop Electrosurgical Excision Procedure (LEEP) is used to treat pre-invasive HPV-mediated disease and patients are typically followed for 12 months after disease excision. This study aims to quantify the prevalence of high-grade disease at the time of the second follow-up colposcopy visit, in a practice setting that utilizes laser ablation in addition to LEEP. Methods In a retrospective cohort study, consecutive patient charts were accessed through the electronic medical record system, ARIA, at the Tom Baker Cancer Centre, in Calgary, Alberta, from January 2010 to December 2015. Data was extracted and a REDCap database was used to compile pertinent information from charts meeting inclusion criteria. Descriptive and analytic statistics were performed. Results Of the 303 patients identified, 221 patients met inclusion criteria. 86% of these patients met discharge criteria from colposcopy after the second follow up visit. 31 (14%) were seen in a subsequent visit for abnormal findings. Of these, 7 (3.2%) underwent further treatment for high-grade disease (CIN 2/3). Of the 31, 23 (10.6%) had a third – negative – visit, resulting in discharge from colposcopy. One patient had a repeat LEEP for persistent LSIL. Conclusion In summary, our data demonstrates a prevalence of 3.2% of high-grade disease at the time of a second colposcopic follow up visit after treatment, in a setting which frequently utilizes laser ablation in combination with LEEP, for large lesions. This recurrence rate is consistent with most published literature on recurrence rates of CIN2/3.

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Defining the short-term disease recurrence after Loop Electrosurgical Excision Procedure (LEEP)

10.21203/rs.2.13812/v4 ◽

2020 ◽

Author(s):

Nicholas Papalia ◽

Amanda Rohla ◽

Selphee Tang ◽

Jill G. Nation ◽

Gregg Nelson

Keyword(s):

Laser Ablation ◽

Clinical Equipoise ◽

Low Grade ◽

High Grade ◽

Inclusion Criteria ◽

Recurrence Rates ◽

Record System ◽

Loop Electrosurgical Excision ◽

Loop Electrosurgical Excision Procedure

Abstract Background The goal of cervical cancer screening is to identify dysplastic lesions for subsequent excision in order to prevent invasive disease. There is clinical equipoise, on how to best follow women for disease surveillance after treatment with some Canadian provinces exclusively performing colposcopy and some utilizing Human Papilloma virus (HPV) testing in addition to cervical cytology. Loop Electrosurgical Excision Procedure (LEEP) is used to treat pre-invasive HPV-mediated disease and patients are typically followed for 12 months after disease excision. This study aims to quantify the prevalence of high-grade disease at the time of the second follow-up colposcopy visit, in a practice setting that utilizes laser ablation in addition to LEEP. Methods In a retrospective cohort study, consecutive patient charts were accessed through the electronic medical record system, ARIA, at the Tom Baker Cancer Centre, in Calgary, Alberta, from January 2010 to December 2015. Data was extracted and a REDCap database was used to compile pertinent information from charts meeting inclusion criteria. Descriptive and analytic statistics were performed. Results Of the 303 patients identified, 221 patients met inclusion criteria. 86% of these patients met discharge criteria from colposcopy after the second follow up visit. 31 (14%) were seen in a subsequent visit for abnormal findings. Of these, 7 (3.2%) underwent further treatment for high-grade disease (Cervical Intraepithelial Neoplasia, CIN 2/3). Of the 31, 23 (10.6%) had a third – negative – visit, resulting in discharge from colposcopy. One patient had a repeat LEEP for persistent Low-Grade Squamous Intraepithelial Lesion (LSIL). Conclusion In summary, our data demonstrates a prevalence of 3.2% of high-grade disease at the time of a second colposcopic follow up visit after treatment, in a setting which frequently utilizes laser ablation in combination with LEEP, for large lesions. This recurrence rate is consistent with most published literature on recurrence rates of CIN2/3.

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