Efficacy and Long-term Outcomes of Repeated Large Loop Excision of the Transformation Zone of the Cervix

Anna J M van de Sande; Coen M Schreuder; Romy van Baars; Margot M Koeneman; Cornelis G Gerestein; Arnold-Jan Kruse; Folkert J van Kemenade; Sten P Willemsen; Heleen J van Beekhuizen

doi:10.1097/AOG.0000000000004663

Efficacy and Long-term Outcomes of Repeated Large Loop Excision of the Transformation Zone of the Cervix

Anna J M van de Sande^*, Coen M Schreuder, Romy van Baars, Margot M Koeneman, Cornelis G Gerestein, Arnold-Jan Kruse, Folkert J van Kemenade, Sten P Willemsen, Heleen J van Beekhuizen

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

OBJECTIVE: To evaluate the efficacy and long-term outcome of repeat large loop excision of the transformation zone in women with residual or recurrent cervical intraepithelial neoplasia.

METHODS: PALGA (the Dutch Pathology Registry), a database of deidentified cervical cytologic and histologic data, was used to examine women with cervical dysplasia who underwent two or more large loop excision of the transformation zone procedures between January 2005 and June 2015. We obtained cervical cytology and histology results. The main outcome was efficacy of repeated large loop excision of the transformation zone procedure in women with residual or recurrent cervical intraepithelial neoplasia. We also examined subsequent excisional procedures and hysterectomy.

RESULTS: We identified 499 women who had undergone two or more large loop excision of the transformation zone procedures. After their second procedure, 60.7% of women had a normal first cervical cytologic sample. The mean duration of follow-up was 68 months (0-163 months). Additional cervical excisional procedures were performed in 33.7% of women. Overall, 1.2% of women developed cervical cancer during follow-up. Moreover, 19.0% of women eventually underwent hysterectomy.

CONCLUSION: One third of the women who undergo two large loop excision of the transformation zone procedures require an additional excisional procedure or hysterectomy. Almost one fifth of these women eventually undergo hysterectomy.

Original language	English
Pages (from-to)	417-422
Number of pages	6
Journal	Obstetrics and Gynecology
Volume	139
Issue number	3
DOIs	https://doi.org/10.1097/AOG.0000000000004663
Publication status	Published - 1 Mar 2022

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10.1097/AOG.0000000000004663Licence: CC BY-NC-ND

Cite this

van de Sande, A. J. M., Schreuder, C. M., van Baars, R., Koeneman, M. M., Gerestein, C. G., Kruse, A.-J., van Kemenade, F. J., Willemsen, S. P., & van Beekhuizen, H. J. (2022). Efficacy and Long-term Outcomes of Repeated Large Loop Excision of the Transformation Zone of the Cervix. Obstetrics and Gynecology, 139(3), 417-422. https://doi.org/10.1097/AOG.0000000000004663

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title = "Efficacy and Long-term Outcomes of Repeated Large Loop Excision of the Transformation Zone of the Cervix",

abstract = "OBJECTIVE: To evaluate the efficacy and long-term outcome of repeat large loop excision of the transformation zone in women with residual or recurrent cervical intraepithelial neoplasia.METHODS: PALGA (the Dutch Pathology Registry), a database of deidentified cervical cytologic and histologic data, was used to examine women with cervical dysplasia who underwent two or more large loop excision of the transformation zone procedures between January 2005 and June 2015. We obtained cervical cytology and histology results. The main outcome was efficacy of repeated large loop excision of the transformation zone procedure in women with residual or recurrent cervical intraepithelial neoplasia. We also examined subsequent excisional procedures and hysterectomy.RESULTS: We identified 499 women who had undergone two or more large loop excision of the transformation zone procedures. After their second procedure, 60.7% of women had a normal first cervical cytologic sample. The mean duration of follow-up was 68 months (0-163 months). Additional cervical excisional procedures were performed in 33.7% of women. Overall, 1.2% of women developed cervical cancer during follow-up. Moreover, 19.0% of women eventually underwent hysterectomy.CONCLUSION: One third of the women who undergo two large loop excision of the transformation zone procedures require an additional excisional procedure or hysterectomy. Almost one fifth of these women eventually undergo hysterectomy.",

author = "{van de Sande}, {Anna J M} and Schreuder, {Coen M} and {van Baars}, Romy and Koeneman, {Margot M} and Gerestein, {Cornelis G} and Arnold-Jan Kruse and {van Kemenade}, {Folkert J} and Willemsen, {Sten P} and {van Beekhuizen}, {Heleen J}",

note = "Copyright {\textcopyright} 2022 The Author(s). Published by Wolters Kluwer Health, Inc.",

year = "2022",

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doi = "10.1097/AOG.0000000000004663",

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T1 - Efficacy and Long-term Outcomes of Repeated Large Loop Excision of the Transformation Zone of the Cervix

AU - van de Sande, Anna J M

AU - Schreuder, Coen M

AU - van Baars, Romy

AU - Koeneman, Margot M

AU - Gerestein, Cornelis G

AU - Kruse, Arnold-Jan

AU - van Kemenade, Folkert J

AU - Willemsen, Sten P

AU - van Beekhuizen, Heleen J

PY - 2022/3/1

Y1 - 2022/3/1

N2 - OBJECTIVE: To evaluate the efficacy and long-term outcome of repeat large loop excision of the transformation zone in women with residual or recurrent cervical intraepithelial neoplasia.METHODS: PALGA (the Dutch Pathology Registry), a database of deidentified cervical cytologic and histologic data, was used to examine women with cervical dysplasia who underwent two or more large loop excision of the transformation zone procedures between January 2005 and June 2015. We obtained cervical cytology and histology results. The main outcome was efficacy of repeated large loop excision of the transformation zone procedure in women with residual or recurrent cervical intraepithelial neoplasia. We also examined subsequent excisional procedures and hysterectomy.RESULTS: We identified 499 women who had undergone two or more large loop excision of the transformation zone procedures. After their second procedure, 60.7% of women had a normal first cervical cytologic sample. The mean duration of follow-up was 68 months (0-163 months). Additional cervical excisional procedures were performed in 33.7% of women. Overall, 1.2% of women developed cervical cancer during follow-up. Moreover, 19.0% of women eventually underwent hysterectomy.CONCLUSION: One third of the women who undergo two large loop excision of the transformation zone procedures require an additional excisional procedure or hysterectomy. Almost one fifth of these women eventually undergo hysterectomy.

AB - OBJECTIVE: To evaluate the efficacy and long-term outcome of repeat large loop excision of the transformation zone in women with residual or recurrent cervical intraepithelial neoplasia.METHODS: PALGA (the Dutch Pathology Registry), a database of deidentified cervical cytologic and histologic data, was used to examine women with cervical dysplasia who underwent two or more large loop excision of the transformation zone procedures between January 2005 and June 2015. We obtained cervical cytology and histology results. The main outcome was efficacy of repeated large loop excision of the transformation zone procedure in women with residual or recurrent cervical intraepithelial neoplasia. We also examined subsequent excisional procedures and hysterectomy.RESULTS: We identified 499 women who had undergone two or more large loop excision of the transformation zone procedures. After their second procedure, 60.7% of women had a normal first cervical cytologic sample. The mean duration of follow-up was 68 months (0-163 months). Additional cervical excisional procedures were performed in 33.7% of women. Overall, 1.2% of women developed cervical cancer during follow-up. Moreover, 19.0% of women eventually underwent hysterectomy.CONCLUSION: One third of the women who undergo two large loop excision of the transformation zone procedures require an additional excisional procedure or hysterectomy. Almost one fifth of these women eventually undergo hysterectomy.

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