Outcomes of loop electrosurgical excision procedure for cervical neoplasia in human immunodeficiency virus-infected women

Int J Gynecol Cancer. 2006 May-Jun;16(3):1082-8. doi: 10.1111/j.1525-1438.2006.00518.x.

Abstract

The objective of this study was to evaluate the treatment outcomes and complications in human immunodeficiency virus (HIV)-infected women undergoing loop electrosurgical excision procedure (LEEP) for cervical neoplasia. The medical record of 60 evaluable HIV-infected women who had abnormal Papanicolaou (Pap) smear and underwent LEEP following colposcopy at Chiang Mai University Hospital between May 1998 and June 2004 was reviewed. Thirty-one (51.7%) had associated genital infection at screening. Twenty-five (41.7%) had opportunistic infection, but only 18 (30.0%) were treated with antiretroviral therapy. The most common abnormal Pap smear was high-grade squamous intraepithelial lesion (46.7%), followed by low-grade squamous intraepithelial lesion (40.0%). Forty (66.7%) women had clear surgical margins after LEEP. Only one (1.7%) woman had severe intraoperative hemorrhage. Early and late postoperative hemorrhage were noted in three (5%) women of each period. Localized infection of the cervix was detected in seven (11.7%) women. Two (3.3%) women developed cervical stenosis at 6 months after LEEP. There was no significant difference in overall complications between HIV-infected women and the control group (P= 0.24). Among 60 HIV-infected women, no statistical difference in the rate of margins involvement (P= 1.00) and complications (P= 0.85) could be demonstrated between HIV-infected women who received antiretroviral therapy and those who did not. Disease-free rate at 6 and 12 months were 97.1% and 88%, respectively. These data demonstrated that LEEP appears to be safe and effective in HIV-infected women.

Publication types

  • Controlled Clinical Trial

MeSH terms

  • Adult
  • Case-Control Studies
  • Colposcopy
  • Disease-Free Survival
  • Electrosurgery / methods*
  • Female
  • Humans
  • Middle Aged
  • Neoplasm Invasiveness / diagnosis
  • Papanicolaou Test
  • Treatment Outcome
  • Uterine Cervical Dysplasia / complications*
  • Uterine Cervical Dysplasia / diagnosis
  • Uterine Cervical Dysplasia / surgery*
  • Uterine Cervical Neoplasms / complications*
  • Uterine Cervical Neoplasms / diagnosis
  • Uterine Cervical Neoplasms / surgery*
  • Vaginal Smears