Histological incomplete excision of CIN after large loop excision of the transformation zone (LLETZ) merits careful follow up, not retreatment

Br J Obstet Gynaecol. 1992 Dec;99(12):990-3. doi: 10.1111/j.1471-0528.1992.tb13704.x.


Objective: To quantify and analyse the influence of a histological report of incomplete excision of CIN after LLETZ on frequency of detection of residual CIN.

Design: Review of a computerised database of sequential women treated by LLETZ. Initial follow-up was three months post-treatment.

Setting: The Colposcopy Clinic, Regional Department of Gynaecological Oncology, Queen Elizabeth Hospital, Gateshead, Tyne and Wear, UK.

Subjects: 721 women with CIN diagnosed histologically on LLETZ specimens.

Results: In spite of a first time treatment success rate of 95% at 3 months, only 56% of the women were reported to have complete histological excision of CIN. A report suggesting incomplete excision was more likely with more severe CIN, extensive lesions and involvement of the endocervical canal. Furthermore, 21% with residual CIN had apparent complete excision of CIN at LLETZ.

Conclusions: A histological report of incomplete excision of CIN at LLETZ does not equate with residual disease. The high treatment success rate of LLETZ means that a report of incomplete excision should stimulate close colposcopic and cytologic follow-up to identify the small number of women with residual CIN after therapy.

MeSH terms

  • Carcinoma in Situ / pathology
  • Carcinoma in Situ / surgery*
  • Cervix Uteri / pathology
  • Clinical Protocols
  • Colposcopy / methods*
  • Decision Making
  • Electrocoagulation / methods*
  • Female
  • Humans
  • Uterine Cervical Neoplasms / pathology
  • Uterine Cervical Neoplasms / surgery*