Repeat LEEP conization in patients with cervical intraepithelial neoplasia grade 3 and positive ectocervical margins.

OBJECTIVE

To evaluate the effectiveness of repeat loop electrosurgical excision procedure (LEEP) conization in patients with cervical intraepithelial neoplasia (CIN) grade 3 and positive ectocervical margins.

METHOD: A retrospective study of 56 women who underwent repeat LEEP conization for CIN 3 and positive ectocervical margins.

RESULTS

Final diagnosis after repeat LEEP conization revealed 6 women (10.7%) with microinvasive squamous cell carcinoma (Stage IA1); 1 (1.8%) with CIN 1; 1 (1.8%) with CIN 2; 21 (37.5%) with CIN 3; and 27 (48.2%) with chronic cervicitis. Ectocervical or endocervical margins were negative after repeat LEEP conization in the majority of women, except for 2 patients (3.6%) with CIN 3 and positive ectocervical margins. Recurrence rate for the median follow-up time of 2 years was 6.1% (3 patients).

CONCLUSION

Repeat LEEP conization can reveal undiagnosed microinvasive cervical carcinoma in women with positive ectocervical margins.