You are here

Article Text

Article menu

Download PDFPDF

Poster/ePoster Sessions
09. Prevention of Gynaecologic Cancer
#794 Trichloroacetic acid for the treatment of high-grade squamous intraepithelial lesion of the cervix – a retrospective analysis
Free
  1. Stephanie Greisler1,
  2. Anna Broday2,
  3. Lukas Speiser3,
  4. Sophie Speiser3,
  5. Rasiah Bharathan4,
  6. Richard Schwameis4 and
  7. Paul Speiser4
  1. 1Medical University of Vienna, Department of Dermatology, Vienna, Austria
  2. 2Sigmund Freud University Vienna, Faculty of Medicine, Vienna, Austria
  3. 3Karl Landsteiner University of Health Sciences, Krems, Austria
  4. 4Medical University of Vienna, Gynecologic Cancer Unit, Comprehensive Cancer Center Vienna, Vienna, Austria

Abstract

Introduction/Background High-grade squamous intraepithelial lesion (HSIL) is the compulsory precursor of squamous cell cervical cancer and usually treated with large loop excision of the transformation zone (LLETZ). However, LLETZ may increase the risk of premature delivery, and therefore, in young women with child bearing potential, ablative strategies to treat HSIL are recommended. Trichloroacetic acid (TCA) is analogue of acetic acid and showed remarkable efficacy in the treatment of LSIL in a prospective trial. This is the first large scale retrospective analysis that investigated TCA in the treatment of HPV positive HSIL.

Methodology This retrospective analysis included patients with HSIL (CIN II/III) treated with 85% TCA. After three months colposcopic, histologic and HPV evaluation was performed. If the evaluation revealed HSIL persistence, a second treatment with TCA was offered, and patients were evaluated again after three months. The primary endpoint was treatment efficacy defined as complete histologic remission after treatment. The secondary endpoint was HPV clearance.

Results In total 793 patients with HSIL were treated with TCA. After one TCA treatment 603 patients (76.0%) showed complete histological remission of HSIL, and 543 patients 70.3% showed HPV clearance. 134 patients underwent a second treatment with TCA. After the second treatment 98 patients (77.2%) showed complete histological remission, and 82 patients (64.6%) showed HPV clearance. In total, after two treatments with TCA 701 (88.4%) and 625 (78.8%) of 793 patients showed histologic complete remission of HSIL and HPV clearance, respectively.

Conclusion This is the first large scale retrospective analysis of patients with HSIL treated with TCA. This analysis shows remarkable activity of TCA in patients with HSIL. TCA could become a new, inexpensive and easy to perform treatment standard in patients with HSIL. A prospective randomized controlled multi-centre trial to compare TCA with LLETZ in the treatment of HSIL is planned.

Disclosures No Disclosures

https://doi.org/10.1136/ijgc-2023-ESGO.737

Statistics from Altmetric.com

    Request Permissions

    If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.