Comparison of cold knife cone biopsy and loop electrosurgical excision procedure in the management of cervical XXXX : What is the gold standard?

@entity1 @entity15709 @entity420 @entity5
OBJECTIVE: To compare the outcomes of @entity1 with cervical @entity15709 ( @entity15709 ) treated with cold knife cone (CKC) biopsy or loop electrosurgical excision procedure (LEEP) for the treatment of cervical @entity15709 ( @entity15709 ). STUDY DESIGN: This is a retrospective, population-based cohort study of Western Australian @entity1 with @entity15709 diagnosed between 2001 and 2012. Outcomes included pathological margin status and the incidence of persistent or recurrent endocervical @entity5 ( @entity15709 and @entity420 ) during follow-up (<12months) and surveillance (>= 12months) periods. RESULTS: The study group comprised 338 @entity1 including 107 (32%) treated initially by LEEP and 231 (68%) treated by CKC biopsy. The mean age was 33.2years (range 18 to 76years) and median follow-up interval was 3.6years (range <1year to 11.8years). Overall, 27 (8.0%) @entity1 had @entity15709 persistence/recurrence while 9 (2.7%) were diagnosed with @entity420 during the follow-up and surveillance periods. No @entity1 died of cervical @entity5 within the study period. There were no significant differences in the incidence of persistent and/or recurrent endocervical @entity5 according to the type of excisional procedure. @entity1 with positive biopsy margins were 3.4 times more likely to have disease persistence or recurrence. CONCLUSION(S): LEEP and CKC biopsy appear equally effective in the treatment of @entity15709 for @entity1 wishing to preserve fertility. @entity1 undergoing conservative management for @entity15709 should be closely monitored, particularly if biopsy margins are positive in initial excision specimens. @entity1 and their clinicians should be aware of the potential risks of residual and recurrent disease.
