The impact of LEEP margin status on subsequent abnormal cervical cytology

Objective: To evaluate the relationship between Loop Electrosurgical Excision Procedure (LEEP) margin status and subsequent cytology results to determine the significance of margin status as a predictor for recurrent cervical disease. Methods: A retrospective cohort of women who underwent LEEP for treatment of cervical dysplasia from 1995 to 2006 with subsequent follow-up to 2009 at a single academic institution. Data extracted consisted of information routinely collected during clinic visits including demographic information, LEEP histology results, and cytology results. Results: The analysis was limited to 144 women with documented LEEP margin status and subsequent cytologic follow-up. The women were predominantly white, non-Hispanic, with a mean age of 27 years (range 14 – 62 years). Of the 144 LEEP specimens, 77 had negative margins, and 67 had positive margins (44 ectocervical, 16 endo-cervical, 7 both ecto-cervical and endo-cervical margins involved). Twentythree women required subsequent colposcopy during the follow-up period: 7 with negative margin status and 16 with positive margin status on their initial LEEP. There was no association between LEEP margin status, grade of dysplasia, or depth of excision, and subsequent abnormal cytology (P>0.05 for each). There was no association between positive ecto-cervical or endo-cervical margin status and subsequent abnormal cytology (P>0.05 for each). Conclusion: We were unable to identify factors related to LEEP margin status to predict recurrent abnormal cytology. Thus, we recommend surveillance of all women following LEEP for cervical dysplasia regardless of margin