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A study of treatment failures following large loop excision of the transformation zone for the treatment of cervical intraepithelial neoplasia

  1. Grainne Flannelly Research Fellow 1,
  2. Heather Langhan Medical Student 1,
  3. Lata Jandial Medical Officer (Cytopathology) 2,
  4. Evelyn Mann Consultant 2,
  5. Marion Campbell Statistician 3,
  6. Henry Kitchener Consultant 1,*

Article first published online: 19 AUG 2005

DOI: 10.1111/j.1471-0528.1997.tb11983.x

Issue

BJOG: An International Journal of Obstetrics & Gynaecology

BJOG: An International Journal of Obstetrics & Gynaecology

Volume 104, Issue 6, pages 718–722, June 1997

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How to Cite

Flannelly, G., Langhan, H., Jandial, L., Mann, E., Campbell, M. and Kitchener, H. (1997), A study of treatment failures following large loop excision of the transformation zone for the treatment of cervical intraepithelial neoplasia. BJOG: An International Journal of Obstetrics & Gynaecology, 104: 718–722. doi: 10.1111/j.1471-0528.1997.tb11983.x

Author Information

  1. 1

    Wellbeing Centre for the Prevention of Cervical Cancer, Aberdeen

  2. 2

    Department of Cytopathology, Aberdeen Royal Hospitals NHS Trust, Aberdeen

  3. 3

    Information Services Team, Grampian Health Board, Aberdeen

*Correspondence: Professor H. Kitchener, Department of Obstetrics and Gynaecology and Reproductive Health Care, St Mary's Hospital, Whitworth Park, Manchester M13 OJH, UK.

Publication History

  1. Issue published online: 19 AUG 2005
  2. Article first published online: 19 AUG 2005
  3. Received 27 November 1995 Returned to author 11 March 1996 Resubmission 4 July 1996 Returned for revision 30 July 1996 Revised manuscript received 5 December 1996 Accepted 8 January 1997

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Objective To examine the long term efficacy of large loop excision of the transformation zone (LLETZ) in the treatment of cervical intraepithelial neoplasia (CIN) and to evaluate the relative diagnostic merits of colposcopy and cytology in the follow up of these women.

Design A retrospective examination of cytology, colposcopy and histology records of the first 1000 women treated with LLETZ in Aberdeen from 1989 to 1991.

Setting Colposcopy Clinic Aberdeen Royal Infirmary, Grampian Region, Scotland.

Results Nine hundred and seventy-seven women (97.7%) were seen for follow up at least once and 317 were followed for as long as four years. This comprises 2812 woman years of follow up. The incidence of recurrent CIN was 27/1000 woman years and the cumulative rate of recurrence at four years was 10.1 per 100 women. Twenty-eight of the 59 women (47%) with abnormal colposcopy and proven CIN had a concurrent smear that did not show dyskaryosis.

Conclusions LLETZ is an effective form of treatment for CIN. Colposcopy was useful in the follow up of these women and expedited the treatment of persistent disease. We recommend that any follow up protocol should include a colposcopic assessment and cytological follow up for at least four years following treatment. Further data are required to determine the risk of recurrence beyond this time.

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