Treatment of women with CIN3: LEEP versus hysterectomy-a retrospective study

Abstract

Background: To compare the therapeutic effectiveness of hysterectomy and loop electrosurgical excision procedure (LEEP) in the treatment of cervical intraepithelial neoplasia grade 3 (CIN3), with a focus on recurrence rates and major complications. Methods: This retrospective study included patients operated between January 2017 and December 2021 with a pathological diagnosis of CIN3. Only patients diagnosed with CIN3 for the first time through cervical biopsies were included. Cases with a diagnosis other than CIN3 after LEEP or hysterectomy were excluded. A total of 100 patients were analyzed, with 50 patients undergoing LEEP (Group 1) and 50 undergoing hysterectomy (Group 2). Results: The median follow-up time was 49.5 months (range: 24-84 months). In Group 1, three patients experienced a recurrence of CIN3 during follow-up and underwent repeat excision procedures. In Group 2, one patient developed vaginal intraepithelial neoplasia grade 3 (VaIN3) after hysterectomy. There was no significant difference in recurrence-free survival between the two groups (p = 0.321). Smoking status was not significantly associated with recurrence (p = 0.527). Conclusions: Although no significant difference in recurrence rates was observed between LEEP and hysterectomy for the treatment of CIN3, the small number of recurrences limits the ability to draw definitive conclusions about the superiority of one treatment over the other. Given the well-documented low risk of cervical cancer after LEEP and its minimally invasive nature, LEEP remains the preferred treatment option for CIN3. Further large-scale studies are needed to evaluate the long-term outcomes of different treatment modalities for CIN3.