Large loop excision of the transformation zone (LLETZ) and LLETZ conisation in the management of early squamous carcinoma of the cervix

Summary

In order to evaluate our experience with loop excisional techniques in the diagnosis and treatment of Stage IA cervical squamous carcinoma, we undertook a retrospective review of patients whose early cervical cancer was diagnosed in a large loop excision of the transformation zone (LLETZ) or LLETZ cone specimen. Twenty-two patients were identified. The treatment was considered complete in eight (36 per cent) after loop excision alone. Fourteen patients underwent further surgery—cold knife cone biopsy (n = 2), vaginal hysterectomy (n = 1), abdominal hysterectomy (n = 9) and radical abdominal hysterectomy with pelvic lymphadenectomy (n = 2). One hysterectomy specimen had residual invasive cancer. Subsequent review of patients revealed no evidence of residual disease. The follow-up period was 8 to 48 months. The absence of invasive cancer in 92 per cent of hysterectomy specimens and negative disease status at follow-up in those managed conservatively suggest that loop excisional techniques provide satisfactory complete treatment in selected patients with Stage IA squamous cervical cancer.