Introduction: Better predictors of recurrence are needed in early-stage cervical cancer (ESICC) and adenocarcinoma in situ (AIS). We assessed the correlation of clearance of high-risk human papillomavirus (HR-HPV) after Large Loop Excision of Transformation Zone (LLETZ) in women diagnosed with ESICC and AIS with absence of residual cancer in the final pathology sample. 

Methods: Data collected from 116 women with ESICC and AIS who were positive to HR-HPV and had a repeat HPV test 3-12 weeks post-LLETZ and before final surgical treatment.  We compared characteristics of negative   and positive HR-HPV post-LLETZ. Results: At the post-LLETZ visit 53 women were negative and 63 positives for HR-HPV. The pathological results of women who were HR-HPV negative compared to HR-HPV positive after LLETZ included a significantly higher incidence of adenocarcinoma and AIS. In the negative HR-HPV post-LLETZ  group the final histological specimen, was without malignancy in 51 women( 96.2%) and only 2 (3.8%) had residual cancer. 15 women who underwent radical hysterectomy/trachelectomy after LLETZ, had a normal final histology in 80% and 11.5% of HR-HPV negative and HR-HPV positive, respectively (p<0.001). The negative predictive value for residual cancer if HR-HPV was negative after LLETZ was 96.1%. 

Conclusions: Clearance of HR -HPV a short time after LLETZ has a high correlation with the absence of residual cancer, either in the pathology or in the follow up. HR-HPV negative test after LLETZ might serve as a new parameter for risk assessment and may lead to personalized medicine and to less radical operation in women with ESICC and AIS.

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