Conization for CIN associated with human papillomavirus infection

Abstract

We report results of follow-up by PAP smears and colposcopy in 116 women treated since 1981 by conization for cervical intraepithelial neoplasia with human papillomavirus infection (HPV-CIN). The mean follow-up time was 31.9 (SD 19) months. Preoperative diagnosis was HPV-CIN II (with extension into the endocervix) in 11 cases and HPV-CIN III in 103 cases; two diagnostic conizations were performed. The histological examination of the cone biopsies showed complete excision of CIN in 109 cases (94%). Three patients underwent hysterectomy after conization; one had microinvasion in the cone biopsy, one had suspicion of microinvasion and one had non-radical conization. Three patients (2.6%) were lost to follow-up. After excluding these six patients the primary cure rate of HPV lesions (normal cytological and colposcopical finding after conization) was 82.7%. Four patients (4.6%) had residual CIN after conization. During the follow-up 15 patients had recurrence of HPV infection, only one had HPV-CIN I. HPV 16 was the most common HPV type (56/116, 48.2%) in the conization group and also in the recurrent cases (9/15, 60%). The results support the role of HPV 16 in cervical carcinogenesis.

Human papillomavirus infection and cervical cancer in Brazil: a retrospective study

“…Association of the three parameters were related to recurrence (AOR 9.0, P=0.0000004), reinforcing the idea of co-operation between factors increasing the risk of developing CINs and cancer. Some authors described that 90% of the patients achieved a two-year cure by using treatment procedures similar to ours: cauterization and conization (Yliskoski et al 1991), contrasting to the 80% of cure showed by us in a five-year study. These observations could be attributed to the different periods of analysis, or to the higher frequency of oncogenic HPVs detected in our patients what could be responsible for these lower efficiency in achieving cure.…”