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Long-term follow-up after large-loop excision of the transformation zone: evaluation of 22 years treatment of high-grade cervical intraepithelial neoplasia
  1. D Van Hamont,
  2. M. A.P.C. Van Ham*,
  3. P. H.T.H. Struik-Van Der Zanden*,
  4. K. G.G. Keijser*,
  5. J. Bulten,
  6. W. J.G. Melchers and
  7. L. F.A.G. Massuger*
  1. *Department of Obstetrics and Gynaecology, Nijmegen, The Netherlands
  2. Department of Medical Microbiology, Nijmegen University Centre for Infectious Diseases, Nijmegen, The Netherlands
  3. Department of Pathology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
  1. Address correspondence and reprint requests to: Dennis van Hamont, MD, MSc, Department of Obstetrics and Gynaecology, Radboud, University Nijmegen Medical Centre, P.O. Box 9101,6500 HB Nijmegen, The Netherlands. Email: d.vahamont{at}


Early treatment of cervical intraepithelial neoplasia (CIN) significantly reduces the risk of invasive cancerous progression. Residual and recurrent high-grade CIN should be detected and retreated in an early phase. Therefore, a postsurgery cytologic follow-up protocol was introduced at 3, 6, 9, and 12 months and yearly thereafter for 5 years. The aim of this study is to evaluate the long-term experience in treating high-grade CIN using large-loop excision of the transformation zone (LLETZ). Additionally, the long-term follow-up in this study gains the opportunity to document the pattern of disease recurrence beyond 5 years. The average follow-up of the 1696 women included in this study was 6.5 years. Overall, 8.5% of the patients who underwent LLETZ showed a high-grade repetitive CIN and three patients had invasive carcinoma. Eighty percent of those lesions were probably residual, whereas 20% of all high-grade repetitive lesions appeared more than 2 years after initial surgery and were considered recurrent lesions. Half of the recurrent lesions occurred more than 5 years after LLETZ.

  • cytology
  • follow-up
  • high-grade cervical intraepithelial neoplasia
  • residual and recurrent lesion

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