Archives of Gynecology and Obstetrics

, Volume 284, Issue 2, pp 517–519 | Cite as

Incomplete excision of cervical intraepithelial neoplasia in conization does not require immediate excisional procedure

  • Adriana Bittencourt CampanerEmail author
  • Fernanda Araujo Cardoso
Letter to the Editor

To the editor:

Cervical conization, which is the recommended treatment for cervical intraepithelial neoplasias (CIN) grade 2 and 3 due to the overall high risk of progression to cervical cancer of these lesions, can be performed using traditional technique (cold-knife conization), laser conization and through the loop electrosurgical excision procedure (LEEP) [1, 2, 3]. Moreover, operator experience, costs, patients’ clinical conditions, equipments availability may be a consideration in choosing between these techniques [4].

Despite these differences, many randomized studies have demonstrated that all of the aforementioned techniques present satisfactory and similar results in the treatment of high-grade lesions of the uterine cervix as long as the entire transformation zone is removed [4].

Independent of the type of conization performed, infiltration of the surgical margins by the neoplastic process is a frequently observed reality. The main reasons related to this occurrence are the...


Surgical Margin Cervical Intraepithelial Neoplasia Standardise Incidence Ratio Invasive Cervical Cancer Hormonal Contraception 
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Conflict of interest

The authors declare that they have no conflicts of interest.


  1. 1.
    Mitchell MF, Tortolero-Luna G, Cook E et al (1998) A randomized clinical trial of cryotherapy, laser vaporization, and loop electrosurgical excision for treatment of squamous intraepithelial lesions of the cervix. Obstet Gynecol 92:737PubMedCrossRefGoogle Scholar
  2. 2.
    Spitzer M, Apgar BS, Brotzman GL (2006) Management of histologic abnormalities of the cervix. Am Fam Physician 73(1):105–112PubMedGoogle Scholar
  3. 3.
    Wright TC Jr, Massad LS, Dunton CJ, Spitzer M, Wilkinson EJ, Solomon D, 2006 American Society for Colposcopy and Cervical Pathology-sponsored Consensus Conference (2007) 2006 consensus guidelines for the management of women with cervical intraepithelial neoplasia or adenocarcinoma in situ. J Low Genit Tract Dis 11((4):223–239PubMedCrossRefGoogle Scholar
  4. 4.
    Martin-Hirsch PL, Paraskevaidis E, Kitchener H (2000) Surgery for cervical intraepithelial neoplasia. Cochrane Database Syst Rev (2):CD001318Google Scholar
  5. 5.
    Melnikow J, McGahan C, Sawaya GF, Ehlen T, Coldman A (2009) Cervical intraepithelial neoplasia outcomes after treatment: long-term follow-up from the British Columbia Cohort Study. J Natl Cancer Inst 101(10):721–728PubMedCrossRefGoogle Scholar
  6. 6.
    Rodolakis A, Thomakos N, Haidopoulos D, Antsaklis A (2009) Management of relapsing cervical intraepithelial neoplasia. J Reprod Med 54(8):499–505PubMedGoogle Scholar
  7. 7.
    Ayhan A, Boynukalin FK, Guven S, Dogan NU, Esinler I, Usubutun A (2009) Repeat LEEP conization in patients with cervical intraepithelial neoplasia grade 3 and positive ectocervical margins. Int J Gynaecol Obstet 105(1):14–17PubMedCrossRefGoogle Scholar
  8. 8.
    Siriaree S, Srisomboon J, Kietpeerakool C, Khunamornpong S, Siriaunkgul S, Natpratan A, Pratheapjarus S, Futemwong A, Chantarasenawong U (2006) High-grade squamous intraepithelial lesion with endocervical cone margin involvement after cervical loop electrosurgical excision: what should a clinician do? Asian Pac J Cancer Prev 7(3):463–466PubMedGoogle Scholar
  9. 9.
    Strander B, Andersson-Ellström A, Milsom I, Sparén P (2007) Long term risk of invasive cancer after treatment for cervical intraepithelial neoplasia grade 3: population based cohort study. BMJ 335(7629):1077PubMedCrossRefGoogle Scholar
  10. 10.
    Munk AC, Kruse AJ, van Diermen B, Janssen EA, Skaland I, Gudlaugsson E, Nilsen ST, Baak JP (2007) Cervical intraepithelial neoplasia grade 3 lesions can regress. APMIS 115(12):1409–1414PubMedCrossRefGoogle Scholar
  11. 11.
    Johansson M, Lycke NY (2003) Immunology of the human genital tract. Curr Opin Infect Dis 16(1):43–49PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • Adriana Bittencourt Campaner
    • 1
    Email author
  • Fernanda Araujo Cardoso
    • 1
  1. 1.Department of Obstetrics and GynecologySanta Casa of São Paulo Medical SchoolSão PauloBrazil

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