Long-term follow-up results of topical imiquimod for high-grade cervical intraepithelial neoplasia in young women: an original research.
4 affiliations
- 1Department of Obstetrics and Gynecology, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju, Republic of Korea.
- 2Department of Obstetrics and Gynecology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea.
- 3Department of Obstetrics and Gynecology, Chungbuk National University Hospital, Cheongju, Republic of Korea.
- 4Department of Obstetrics and Gynecology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea. [email protected].
Abstract
Background
Cervical excisional treatment is associated with adverse obstetric outcomes. Although imiquimod has been explored as a conservative alternative in trials like TOPIC-3, its definitive role remains debated. We aimed to evaluate the long-term efficacy of a clinician-applied imiquimod strategy specifically in women aged under 35 years to verify its potential for fertility preservation.Methods
We conducted a retrospective, single-arm cohort study of nulliparous women aged under 35 years with Cervical Intraepithelial Neoplasia (CIN) 2 or 3 and no prior excisional therapy between October 2021 and March 2024. The primary outcomes were histological regression assessed immediately post-treatment (8 weeks) and during a prolonged follow-up period.Results
A total of 100 patients were included. The immediate regression rate following the 8-week imiquimod course was 96.0%, with an initial high risk Human Papillomavirus (hr-HPV) clearance rate of 57.1%. In the follow-up analysis, the sustained regression rate reached 91.0%, and the cumulative hr-HPV clearance rate rose to 70.5%. Notably, patients with CIN2 without HPV 16/18 achieved the highest regression rate (96.5%), successfully avoided or postponed surgical intervention.Conclusions
The clinician-applied imiquimod strategy offers a robust therapeutic impact, safely postponing surgical intervention for approximately one year in reproductive-aged women with CIN 2/3. This imiquimod strategy serves as an effective bridging therapy that preserves fertility without compromising clinical safety, providing a supportive clinical decision-making model for individualized non-surgical management.
Related
- Association between lesion location and cervical intraepithelial neoplasia
- Cytokine Profiles in Cervical Intraepithelial Neoplasia: Associations with Lesion Severity and Exploratory Treatment Response
- Efficacy of Thermo-Coagulation as a Treatment Modality for Cervical Intraepithelial Neoplasia-1 and Cervical Intraepithelial Neoplasia-2 Lesions
- Real-world clinical outcomes of 5-aminolevulinic acid photodynamic therapy in patients with cervical intraepithelial neoplasia grade 1
- cGAS-STING pathway-related genes as candidate molecules associated with cervical intraepithelial neoplasia: an exploratory bioinformatics analysis
BibTeX
@article{kim2026longterm,
title = {{Long-term follow-up results of topical imiquimod for high-grade cervical intraepithelial neoplasia in young women: an original research.}},
author = {Jungmi Kim and Ju-Hyun Kim and Yaesol Kim and Rumie Lee and Hyeonji Choi and Dae-Yeon Kim},
journal = {BMC women's health},
year = {2026},
month = aug,
doi = {10.1186/s12905-026-04685-8},
url = {https://europepmc.org/article/MED/43009930},
note = {CC BY},
}
RIS
TY - JOUR
TI - Long-term follow-up results of topical imiquimod for high-grade cervical intraepithelial neoplasia in young women: an original research.
AU - Jungmi Kim
AU - Ju-Hyun Kim
AU - Yaesol Kim
AU - Rumie Lee
AU - Hyeonji Choi
AU - Dae-Yeon Kim
PY - 2026
DA - 2026/08/14
JO - BMC women's health
DO - 10.1186/s12905-026-04685-8
UR - https://europepmc.org/article/MED/43009930
AB - Background Cervical excisional treatment is associated with adverse obstetric outcomes. Although imiquimod has been explored as a conservative alternative in trials like TOPIC-3, its definitive role remains debated. We aimed to evaluate the long-term efficacy of a clinician-applied imiquimod strategy specifically in women aged under 35 years to verify its potential for fertility preservation.Methods We conducted a retrospective, single-arm cohort study of nulliparous women aged under 35 years with Cervical Intraepithelial Neoplasia (CIN) 2 or 3 and no prior excisional therapy between October 2021 and March 2024. The primary outcomes were histological regression assessed immediately post-treatment (8 weeks) and during a prolonged follow-up period.Results A total of 100 patients were included. The immediate regression rate following the 8-week imiquimod course was 96.0%, with an initial high risk Human Papillomavirus (hr-HPV) clearance rate of 57.1%. In the follow-up analysis, the sustained regression rate reached 91.0%, and the cumulative hr-HPV clearance rate rose to 70.5%. Notably, patients with CIN2 without HPV 16/18 achieved the highest regression rate (96.5%), successfully avoided or postponed surgical intervention.Conclusions The clinician-applied imiquimod strategy offers a robust therapeutic impact, safely postponing surgical intervention for approximately one year in reproductive-aged women with CIN 2/3. This imiquimod strategy serves as an effective bridging therapy that preserves fertility without compromising clinical safety, providing a supportive clinical decision-making model for individualized non-surgical management.
SN - 1472-6874
ER -