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Re: Gyn: CISFrom: Dr. John Provatopoulos B.Sc. M.D.C.M. F.R.S.C. (johnprov@sympatico.ca)Tue Sep 25 12:55:46 2007
In first case 23P0, I would just repeat the PAP in six months, there is now good data the more you Leep the more likely to have prem labour in the future. The second case I would probably just repeat PAP again in six months, but here there is a chance 33 P2 may have completed her child bearing so repeat leep or even Hyst if other problems coexist is resonable. There was a recent good review which showed actual surface area of high grade lesion near the margins endo or ecto is more important in predictating residual HGSIL or reccurance (take your pick.) , than just having a small focus of HGSIL near a margin. So hopefully pathologists will describe how much HGSIL is in a LEEP specimen.
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Take care, John
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