Tatjana Hanczuk1, Martin Weiss2, Leon Henes2, Tobias Engler2, Felix Neis2, Melanie Henes3. 1. Eberhard Karls University of Tübingen, Tübingen, Germany. 2. Department of Women's Health, University Hospital Tübingen, Calwerstraße 7, 72076, Tübingen, Germany. 3. Department of Women's Health, University Hospital Tübingen, Calwerstraße 7, 72076, Tübingen, Germany. melanie.henes@med.uni-tuebingen.de.
Abstract
PURPOSE: This study evaluates the overall treatment indicators and outcomes of patients who underwent loop electrosurgical excision procedure (LEEP) at the Department of Women's Health Tübingen and the impact of certification as a dysplasia unit on treatment quality. METHODS: Retrospective data analysis of 1596 patients from 2013 to 2018 who underwent LEEP excision at the Department of Women's Health Tübingen. Data of cytology, colposcopy, biopsy, LEEP histology, repeat LEEP histology and general characteristics were collected and analyzed descriptively. RESULTS: 85.4% (1364) of patients had CIN 2 + and 14.6% (232) had CIN 1 or normal findings on LEEP histology. The proportion of CIN 2 + excisions increased significantly from 82.4% in 2013 to 89% in 2018. The concordance of HSIL biopsy and LEEP histology was 89.1% in 2013 and 92.6% in 2018. In 2018, more biopsies and colposcopies were performed before excision. Complete resection (R0) was achieved in 88.3% of all excisions. R0 rates in patients with CIN 3 increased in 2014-2017 compared to 2013, resulting in fewer Re-LEEP excisions and hysterectomies. CONCLUSION: Certification as a dysplasia unit and the associated requirements have improved the diagnostic quality for patients with cervical dysplasia undergoing LEEP. This was demonstrated by several treatment indicators such as the number of colposcopies and biopsies and treatment outcomes such as an increased proportion of CIN 2 + excisions and R0 resections.
PURPOSE: This study evaluates the overall treatment indicators and outcomes of patients who underwent loop electrosurgical excision procedure (LEEP) at the Department of Women's Health Tübingen and the impact of certification as a dysplasia unit on treatment quality. METHODS: Retrospective data analysis of 1596 patients from 2013 to 2018 who underwent LEEP excision at the Department of Women's Health Tübingen. Data of cytology, colposcopy, biopsy, LEEP histology, repeat LEEP histology and general characteristics were collected and analyzed descriptively. RESULTS: 85.4% (1364) of patients had CIN 2 + and 14.6% (232) had CIN 1 or normal findings on LEEP histology. The proportion of CIN 2 + excisions increased significantly from 82.4% in 2013 to 89% in 2018. The concordance of HSIL biopsy and LEEP histology was 89.1% in 2013 and 92.6% in 2018. In 2018, more biopsies and colposcopies were performed before excision. Complete resection (R0) was achieved in 88.3% of all excisions. R0 rates in patients with CIN 3 increased in 2014-2017 compared to 2013, resulting in fewer Re-LEEP excisions and hysterectomies. CONCLUSION: Certification as a dysplasia unit and the associated requirements have improved the diagnostic quality for patients with cervical dysplasia undergoing LEEP. This was demonstrated by several treatment indicators such as the number of colposcopies and biopsies and treatment outcomes such as an increased proportion of CIN 2 + excisions and R0 resections.
Authors: Nicolas Wentzensen; Joan L Walker; Michael A Gold; Katie M Smith; Rosemary E Zuna; Cara Mathews; S Terence Dunn; Roy Zhang; Katherine Moxley; Erin Bishop; Meaghan Tenney; Elizabeth Nugent; Barry I Graubard; Sholom Wacholder; Mark Schiffman Journal: J Clin Oncol Date: 2014-11-24 Impact factor: 44.544
Authors: Frederik A Stuebs; Carla E Schulmeyer; Grit Mehlhorn; Paul Gass; Sven Kehl; Simone K Renner; Stefan P Renner; Carol Geppert; Werner Adler; Arndt Hartmann; Matthias W Beckmann; Martin C Koch Journal: Arch Gynecol Obstet Date: 2018-10-27 Impact factor: 2.344