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EPV237/#541 Two-year effectiveness of topical imiquimod treatment of high-grade cervical intraepithelial neoplasia (TOPIC-3)
  1. N Hendriks1,
  2. M Koeneman2,
  3. B Slangen1 and
  4. A-J Krüse3
  1. 1Maastricht University Medical Center, Gynaecology and Obstetrics, Maastricht, Netherlands
  2. 2Rivierenland Ziekenhuis, Obstetrics and Gynaecology, Tiel, Netherlands
  3. 3Isala Clinics, Obstetrics and Gynaecology, Zwolle, Netherlands


Objectives Imiquimod could be offered as a non-surgical treatment alternative to LLETZ in treatment of high-grade CIN, for women who wish to avoid surgery. Short term effectiveness of imiquimod is 60–70%. In the current study, we present the two-year follow-up results after successful initial imiquimod treatment, compared to LLETZ treatment.

Methods We performed a multi-center, non-randomized trial, in which women with a histological diagnosis of CIN 2/3 were treated with either imiquimod during 16 weeks or underwent LLETZ. All women who had initial successful treatment were included in further analysis.

Follow-up consisted of regular pap smears according to Dutch guidelines during two years. Successful treatment was defined as no histologic CIN 2/3 diagnosis during follow-up.

Results A total of 84 women were included in the analysis (27 from the imiquimod group and 57 from the LLETZ group). CIN2/3 was diagnosed in one woman (2%) in LLETZ group and two women in the imiquimod group (7%), all underwent additional LLETZ treatment (p=0.26). For both entire groups, HPV status at 2 year follow-up was similar. CIN grade at inclusion, HPV status at short term follow-up, age, parity and smoking were not identified as factors associated with successful treatment.

Abstract EPV237/#541 Table 1

Two-year treatment effectiveness

Conclusions Disease recurrence of high-grade CIN two years after successful treatment with imiquimod is infrequent and is not statistically different from LLETZ treatment. This indicates a lasting effectiveness of imiquimod treatment.

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