Page 172 - Strategies for non-invasive managementof high-grade cervical intraepithelial neoplasia - prognostic biomarkers and immunotherapy Margot Maria Koeneman

Chapter 9a
of application of the imiquimod cream until the vaginal shower the next morning. A control colposcopy with diagnostic biopsies is performed after ten weeks to rule out disease progression. Biopsies are performed at the initial high-grade CIN lesion site and at any other suspect site, with a minimum of two. In case of progressive disease (defined as increase in lesions size with stable disease grade, higher disease grade or invasive disease), surgical excision is performed.
Treatment efficacy for the experimental arm is evaluated at 20 weeks follow-up, by colposcopy with diagnostic biopsies. Biopsies are performed by using a cervical biopsy specimen forceps (Aesculap ER055R), at the initial high-grade CIN lesion site and at any other suspect site, with a minimum of two. In case of persistent or progressive disease (> CIN 1), surgical excision is performed.
Patients in the standard treatment arm undergo LLETZ at short term (within 4 weeks after the diagnosis). Excision of the transformation zone and macroscopic lesions is performed by a monopolar loop electrode, under local anaesthesia. A summary of study interventions can be found in figure 1.
Figure 1. Summary of study interventions
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