TY - JOUR
T1 - Lugol's Solution Reduces Positive Margins and Residual Disease After the Large Loop Excision of Transformation Zone
AU - Kim, Min Jeong
AU - Lee, Grace J.
AU - Lee, Eun Ji
AU - Lee, Seungmee
AU - Chay, Doo Byung
AU - Lee, Chae Hyeong
AU - Kim, Jae Hoon
AU - Roh, Ju Won
N1 - Publisher Copyright:
© 2023 Lippincott Williams & Wilkins.
PY - 2024/1/1
Y1 - 2024/1/1
N2 - Objective: This study aimed to examine whether the intraoperative use of Lugol's solution reduces the proportion of positive resection margins (RMs) using the data of women who underwent large loop excision of the transformation zone (LLETZ). Materials and Methods: A total of 1,751 consecutive women with cervical intraepithelial neoplasia (CIN) who underwent LLETZ with or without Lugol's solution were retrospectively retrieved from each database of 3 university hospitals in South Korea. Outcomes included positive RMs and residual disease pathologically confirmed within 6 months after LLETZ. Results: Positive RMs were noted in 345 cases (19.7%). Among 1,507 women followed up, residual disease was diagnosed in 100 cases (6.6%) (69/308 cases with positive RMs; 31/1,199 cases with negative RMs). The Lugol's solution group was less likely to have positive RMs (11.8% vs 25.5%, p <.01), to require additional surgical intervention (5.4% vs 10.2%, p <.01), and to have residual disease (4.9% vs 8.0%, p =.02). On multiple logistic regression analysis, Lugol's solution reduced the proportion of positive RMs (adjusted odds ratio [aOR], 0.31). Age (50 years or older; aOR, 1.64), preconization cervical cytology (aOR, 1.53), high-risk human papillomavirus (aOR, 1.75), and CIN 2 or 3 (aOR, 2.65) were independent risk factors for margin positivity (p <.01 for all except high-risk human papillomavirus of p =.05). Conclusions: Lugol's solution optimizes CIN treatment by reducing the proportion of positive RMs and residual disease after LLETZ.
AB - Objective: This study aimed to examine whether the intraoperative use of Lugol's solution reduces the proportion of positive resection margins (RMs) using the data of women who underwent large loop excision of the transformation zone (LLETZ). Materials and Methods: A total of 1,751 consecutive women with cervical intraepithelial neoplasia (CIN) who underwent LLETZ with or without Lugol's solution were retrospectively retrieved from each database of 3 university hospitals in South Korea. Outcomes included positive RMs and residual disease pathologically confirmed within 6 months after LLETZ. Results: Positive RMs were noted in 345 cases (19.7%). Among 1,507 women followed up, residual disease was diagnosed in 100 cases (6.6%) (69/308 cases with positive RMs; 31/1,199 cases with negative RMs). The Lugol's solution group was less likely to have positive RMs (11.8% vs 25.5%, p <.01), to require additional surgical intervention (5.4% vs 10.2%, p <.01), and to have residual disease (4.9% vs 8.0%, p =.02). On multiple logistic regression analysis, Lugol's solution reduced the proportion of positive RMs (adjusted odds ratio [aOR], 0.31). Age (50 years or older; aOR, 1.64), preconization cervical cytology (aOR, 1.53), high-risk human papillomavirus (aOR, 1.75), and CIN 2 or 3 (aOR, 2.65) were independent risk factors for margin positivity (p <.01 for all except high-risk human papillomavirus of p =.05). Conclusions: Lugol's solution optimizes CIN treatment by reducing the proportion of positive RMs and residual disease after LLETZ.
KW - cervical intraepithelial neoplasm
KW - conization
KW - resection margins
KW - residual tumors
UR - http://www.scopus.com/inward/record.url?scp=85180533136&partnerID=8YFLogxK
U2 - 10.1097/LGT.0000000000000784
DO - 10.1097/LGT.0000000000000784
M3 - Article
C2 - 38032756
AN - SCOPUS:85180533136
SN - 1089-2591
VL - 28
SP - 12
EP - 17
JO - Journal of Lower Genital Tract Disease
JF - Journal of Lower Genital Tract Disease
IS - 1
ER -