The role of HPV DNA testing in the follow-up of cervical intraepithelial neoplasia after loop electrosurgical excision procedure

Dogan, Nasuh Utku; Salman, Mehmet Çoşkun; Yüce, K.

doi:10.1007/s00404-010-1530-1

Cited by 13 publications

(9 citation statements)

References 36 publications

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“…A total of 45 studies provided estimates on HPV persistence post‐treatment in 6,106 women. Most studies were conducted in Europe (58%) and Asia/Australia (22%), with 18% from North/Central/South America, and 2% from multiple regions (Table ).…”

Section: Resultsmentioning

confidence: 99%

“…Twenty‐four studies in our review examined the association between post‐treatment HPV infection and residual or recurrent CIN . Collectively these studies found that HPV testing after CIN treatment may help detect residual or recurrent disease, and that persistent HPV infection after treatment for CIN was an independent risk factor for recurrence.…”

Section: Discussionmentioning

confidence: 98%

“…Twenty-four studies in our review examined the association between post-treatment HPV infection and residual or recurrent CIN. 12,14,[16][17][18][19]22,25,27,29,31,34,35,37,39,40,[42][43][44]46,48,49,51,52 Collectively these studies found that HPV testing after CIN treatment may help detect residual or recurrent disease, and that persistent HPV infection after treatment for CIN was an independent risk factor for recurrence. It is the general consensus of this literature that HPV testing should be incorporated into the follow-up of patients after treatment for CIN, though not as a replacement for either cytology or colposcopy follow-up procedures.…”

Section: Discussionmentioning

confidence: 99%

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Patterns of persistent HPV infection after treatment for cervical intraepithelial neoplasia (CIN): A systematic review

Hoffman¹,

Lockhart³

et al. 2017

Intl Journal of Cancer

107

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A systematic review of the literature was conducted to determine the estimates of and definitions for human papillomavirus (HPV) persistence in women following treatment of cervical intra-epithelial neoplasia (CIN). A total of 45 studies presented data on post-treatment HPV persistence among 6,106 women. Most studies assessed HPV persistence after loop excision (42%), followed by conization (7%), cryotherapy (11%), laser treatment (4%), interferon-alpha, therapeutic vaccination, and photodynamic therapy (2% each) and mixed treatment (38%). Baseline HPV testing was conducted before or at treatment for most studies (96%). Follow-up HPV testing ranged from 1.5 to 80 months after baseline. Median HPV persistence tended to decrease with increasing follow-up time, declining from 27% at 3 months after treatment to 21% at 6 months, 15% at 12 months, and 10% at 24 months. Post-treatment HPV persistence estimates varied widely and were influenced by patient age, HPV-type, detection method, treatment method, and minimum HPV post-treatment testing interval. Loop excision and conization appeared to outperform cryotherapy procedures in terms of their ability to clear HPV infection. This systematic review provides evidence for the substantial heterogeneity in post-treatment HPV DNA testing practices and persistence estimates.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

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Patterns of persistent HPV infection after treatment for cervical intraepithelial neoplasia (CIN): A systematic review

Hoffman¹,

Lockhart³

et al. 2017

Intl Journal of Cancer

107

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“…Monitoring women after trachelectomy with HPV DNA testing could probably be a diagnostic tool in the follow-up procedure. Others have shown that HPV DNA testing leads to a significant rise in sensitivity when used as an additional diagnostic tool to cytological screening methods and thus contributes to detect emerging dysplasia and thereby reducing the incidence of cervical carcinomas [28].…”

Section: Oncologic Outcomementioning

confidence: 99%

Vaginal Radical Trachelectomy for early stage cervical cancer. Results of the Danish National Single Center Strategy

Hauerberg

Høgdall

Loft

et al. 2015

Gynecologic Oncology

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“…There is growing evidence that preconisation HPV testing strongly predicts the behavior of preinvasive lesions. The risk of progression is low in the absence of HR-HPV and high in their presence especially with positive excision margins [7,17,32,33].…”

Section: Discussionmentioning

confidence: 99%

Implications of Post-LLETZ “Treatment Failure” for Further Management of HIV-Infected Women

Bogaert

2014

Journal of Cancer Research

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Background. Since the preconisation presence of high-risk human papillomavirus (HR-HPV) is the main determinant of the risk of progression of preinvasive lesions; the state of the excision margins could be of less importance. Relatively little is known about the effect of human immunodeficiency virus (HIV) infection on the relation between the states of the excision margins. Methods. We compared 120 HIV-infected and 139 HIV-uninfected women who underwent a hysterectomy after large loop excision of the transformation zone (LLETZ) for abnormal Pap smear. Results. The excision margins had been reported negative in 21.7% of infected and 7.8% of uninfected cases ( = 0.03). Three (11.5%) of 26 negative margins in HIV-infected and 2 (18.2) out of HIV-uninfected cases were falsely negative as evidenced on hysterectomy specimens ( = 0.73). The persistence rate of the initial lesion was similar in both groups ( = 0.20). The persistence rate with highly active antiretroviral treatment (HAART) was similar to untreated patients ( = 0.20). The progression rate from low-grade to high-grade preinvasive lesions was higher in HIV-infected than HIVuninfected women ( = 0.027). Conclusion. HIV-infected women with incomplete excision margins after LLETZ are at higher risk of progression of residual preneoplastic lesions.

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The role of HPV DNA testing in the follow-up of cervical intraepithelial neoplasia after loop electrosurgical excision procedure

Abstract: LEEP does not seem to decrease HPV DNA incidence for CIN 1 at least for 6 months. But HPV DNA used in addition to cytology might help to detect recurrences.

Cited by 13 publications

References 36 publications

Patterns of persistent HPV infection after treatment for cervical intraepithelial neoplasia (CIN): A systematic review

Patterns of persistent HPV infection after treatment for cervical intraepithelial neoplasia (CIN): A systematic review

Vaginal Radical Trachelectomy for early stage cervical cancer. Results of the Danish National Single Center Strategy

Implications of Post-LLETZ “Treatment Failure” for Further Management of HIV-Infected Women

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