“Three-Step Approach” Versus “See-and-Treat Procedure” in women with “High Grade Squamous Intraepithelial Lesion” (HSIL) or “Atypical Squamous Cells cannot exclude HSIL” (ASC-H) Cytology

Authors

  • Mustafa Erkan Sari University of Health Sciences Zekai Tahir Burak Women's Health Training and Research Hospital
  • Ibrahim Yalcin University of Health Sciences Zekai Tahir Burak Women's Health Training and Research Hospital
  • Hanifi Sahin University of Health Sciences Zekai Tahir Burak Women's Health Training and Research Hospital
  • Mehmet Mutlu Meydanli University of Health Sciences Zekai Tahir Burak Women's Health Training and Research Hospital
  • Tayfun Gungor University of Health Sciences Zekai Tahir Burak Women's Health Training and Research Hospital

DOI:

https://doi.org/10.21613/GORM.2017.743

Keywords:

See and treat Strategy, Cytology, Colposcopy

Abstract

Objective: The purpose of this study was to examine the correlation between histological findings in women with HSIL or ASC-H who have undergone loop electrosurgical excisional procedure with “Three-Step Approach” and “See-and-Treat Procedure".

Study Design: A retrospective review was performed in 171 women with cytologically detected HSIL or ASC-H. Sixty five women with HSIL cytology and 35 women with ASC-H cytology were managed by “Three-Step Approach”, 35 women with ASC-H and 36 women with HSIL cytology were managed by "See-and-Treat Procedure”. Rates of histopathological findings were compared in two strategies with respect to previous cytology.

Results: Fifteen women with ASC-H (42.9%), and 24 women with HSIL (68.5%) had CIN 2-3 at loop electrosurgical excisional procedure specimens in the “See-and-Treat” group whereas 14 women with ASC-H (38.8%), and 43 women with HSIL (66.2%) had CIN 2-3 at loop electrosurgical excisional procedure specimens in the “Three-Step Approach” group. There was no significant difference in the rate of CIN 2+ lesions when two strategies were compared in women with HSIL and ASC-H (p=0.71 and p=0.72, respectively). The overtreatment rates were 22.9% and 48.6% for HSIL and ASC-H cytology, respectively in the “See and Treat” group.

Conclusion: In the ASC-H group, the rate of CIN 2+ lesions is significantly high (51.4%). It seems rational to perform “See-and-Treat procedure” in the setting of ASC-H smears although the overtreatment rate seems to be high. Because of the rate of overtreatment, the “Three-Step Approach” seems to be more reasonable in women with ASC-H cytology who also have fertility concerns. After a cytological diagnosis of HSIL, “see and treat” approach seems to be a safe and time saving strategy.

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Author Biographies

Mustafa Erkan Sari, University of Health Sciences Zekai Tahir Burak Women's Health Training and Research Hospital

Department of Gynecologic Oncology

Ibrahim Yalcin, University of Health Sciences Zekai Tahir Burak Women's Health Training and Research Hospital

Department of Gynecologic Oncology

Hanifi Sahin, University of Health Sciences Zekai Tahir Burak Women's Health Training and Research Hospital

Department of Gynecologic Oncology

Mehmet Mutlu Meydanli, University of Health Sciences Zekai Tahir Burak Women's Health Training and Research Hospital

Department of Gynecologic Oncology

Tayfun Gungor, University of Health Sciences Zekai Tahir Burak Women's Health Training and Research Hospital

Department of Gynecologic Oncology

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Published

2018-12-25

How to Cite

1.
Sari ME, Yalcin I, Sahin H, Meydanli MM, Gungor T. “Three-Step Approach” Versus “See-and-Treat Procedure” in women with “High Grade Squamous Intraepithelial Lesion” (HSIL) or “Atypical Squamous Cells cannot exclude HSIL” (ASC-H) Cytology. Gynecol Obstet Reprod Med [Internet]. 2018Dec.25 [cited 2021Apr.15];24(3):151-5. Available from: https://www.gorm.com.tr/index.php/GORM/article/view/743

Issue

Section

Gynecology and Gynecological Oncology

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