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Comparison of cure rates in women treated with cold-coagulation versus LLETZ cervical treatment for CIN2-3 on pretreatment cervical punch biopsies: a retrospective cohort study

  • Gynecologic Oncology
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Purpose

To compare the cure rates between women who were treated with cold-coagulation versus large loop excision of the transformation zone (LLETZ) for cervical intraepithelial neoplasia grade 2 (CIN2) or 3 (CIN3) on pretreatment cervical punch biopsies.

Methods

This was a retrospective cohort study of women having had a single cervical treatment for CIN2 or CIN3 on pretreatment cervical punch biopsies between 2010 and 2011. The cure rates were defined as the absence of any dyskaryosis (mild/moderate/severe) on cytology tests during follow-up and were determined at 6 and 12 months after treatment.

Results

We identified 411 women having had cervical treatment with 178 cases of cold-coagulation and 233 cases of LLETZ. The cure rates at 6 months following cold-coagulation and LLETZ treatment were 91.6 versus 97.1% (p = 0.02), whereas at 12 months, they were 96.5 versus 97.3% (p = 0.76). Multivariable analysis showed that after adjusting for confounding factors, there was a fourfold higher cure rate with LLETZ in comparison with cold-coagulation at 6 months after treatment (adjusted OR 4.50, 95% CI 1.20–16.83; p = 0.026), with this difference disappearing at 12 months. The lower cure rates with cold-coagulation were due to its higher rates of mild dyskaryosis cytology tests at 6 months. The rates of moderate/severe dyskaryosis cytology tests were similar between the two treatment methods at 6 and 12 months.

Conclusion

We found that women with CIN2 or CIN3 on pretreatment cervical punch biopsies, after adjusting for multiple confounding factors, had higher cure rates when treated with LLETZ versus cold-coagulation at 6 months, with this difference disappearing at 12 months.

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Author contributions

DP: Protocol/project development, Data collection and data management, Data analysis, Manuscript writing and editing. MU: Protocol/project development, Data collection and data management, Data analysis, Manuscript writing and editing. WP-S: Protocol/project development, Data collection and data management, Data analysis, Manuscript writing and editing. JP: Protocol/project development, Manuscript writing/editing.

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Authors and Affiliations

  1. Department of Obstetrics and Gynaecology, Shrewsbury and Telford Hospitals NHS Trust, Princess Royal Hospital, Apley Castle, Grainger Drive, Telford, TF16TF, UK

    Dimitrios Papoutsis, Martyn Underwood, William Parry-Smith & Jane Panikkar

Authors
  1. Dimitrios Papoutsis
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  2. Martyn Underwood
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  3. William Parry-Smith
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  4. Jane Panikkar
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Corresponding author

Correspondence to Dimitrios Papoutsis.

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The authors declare that they have no conflict of interest.

Informed consent

Our study was a retrospective study, and for this type of study, formal consent is not required.

Research involving human participants and/or animals

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Papoutsis, D., Underwood, M., Parry-Smith, W. et al. Comparison of cure rates in women treated with cold-coagulation versus LLETZ cervical treatment for CIN2-3 on pretreatment cervical punch biopsies: a retrospective cohort study. Arch Gynecol Obstet 295, 979–986 (2017). https://doi.org/10.1007/s00404-017-4306-z

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  • DOI: https://doi.org/10.1007/s00404-017-4306-z

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