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1044 Outpatient management of cervical glandular intraepithelial neoplasia: an audit of 5-year follow-up outcomes
  1. Hajar Essangri1,
  2. Mark R Brincat2,
  3. Ana Rita Mira3,
  4. Michail Sideris1,
  5. Saurabh Phadnis2 and
  6. Anna Parberry3
  1. 1Department of Gynaecological Oncology, London, UK
  2. 2Royal London Hospital, London, UK
  3. 3Barts Health NHS Trust, London, UK


Introduction/Background Cervical Glandular Intraepithelial Neoplasia (CGIN) is a premalignant glandular lesion, commonly regarded as multifocal HPV-associated entity. Due to its higher risk of recurrence, rigorous follow-up is required. We audit the outcomes of CGIN treatment in the outpatient setting in a tertiary cancer centre.

Methodology We included consecutive patients who underwent colposcopic examination and subsequent treatment for suspected CGIN in the form of large loop excision of the transformation zone (LLETZ) between 2011–2018. Data were retrospectively collected and included age, histopathology (size of the specimen, margin status), test of cure (TOC) result and recurrence until 5 years follow-up. SPSS was used for statistical analysis.

Results Fifty-four patients, with a mean age of 32.72 years(±5.96) were included in the audit. Assessment revealed low-grade colposcopic changes in 4 (7.4%) cases, high-grade changes in 39 (72.2%), and suspected invasive disease in 6 (11.1%). Forty-six patients (85.2%) had a negative endocervical excision margin, 47 (87%) negative radial margin and 39 (72.2%) negative ectocervical margin. The volume of excision did not correlate with the status of the endocervix, radial or ectocervical margins (p>0.05). An excision depth of less than 10mm was correlated with positive endocervical margins (CGIN or CIN) (p=0.045). Six patients (11.1%) had CGIN identified at the endocervical margin, 7 (13%) at the radial and 3 (5.6%) at the ectocervical margin. Recurrence of CGIN was not observed in this cohort until 5 years of follow-up. One out of the 5 patients who had CGIN detected at the endocervical margin was found to have intraepithelial neoplasia (CIN1) during follow-up. Volume and depth of excision, margin status and concurrent lesions found in the specimen (SMILE or CIN), did not affect TOC status or CGIN recurrence rate.(p>0.05)

Conclusion Outpatient LLETZ biopsy is an effective treatment for CGIN. Within our cohort, involved margins did not increase risk of recurrence.

Disclosures None declared.

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