Predictive Factors for Residual Disease in Subsequent Hysterectomy Following Conization for CIN III

Endocervical glandular involvement, multicentricity, and extent of the disease are features of high-grade cervical intraepithelial neoplasia

“…Previously reported studies related endocervical glandular involvement to higher recurrence after LEEP [2,[8][9][10][11][12]. Opposing results were also reported [13,14]. Bearing these in mind, low-grade CIN with endocervical glandular involvement can be considered as lesions with higher potential for recurrence, and closer follow-up can be advised.…”

“…Previously, Fadare et al [7] reported that the extent of lesions was not an important factor for recurrence when surgical margins were negative. In contrast, other studies reported higher recurrence rates as the number of involved quadrants increased [8,13,14].…”

Role of high risk-human papilloma virus test in the follow-up of patients who underwent conization of the cervix for cervical intraepithelial neoplasia

“…Factors reported to be associated with persistent or recurrent cervical neoplasms after conization include menopausal status, grade of dysplasia, follow-up cervical cytology, cone diagnosis of CIN 3, cone margin status, and positive endocervical curettage. However, these factors are suboptimal predictors, [4][5][6][7][8][9][10][11][12] and cannot be used to dictate the follow-up strategy after conization. While there is increasing evidence that testing for the presence of high risk-human papilloma virus (HR-HPV) after conization may help predict the likelihood of persistent or recurrent disease, 1,[13][14][15][16][17][18][19][20][21][22] no study has shown how HR-HPV testing might be integrated into post conization surveillance.…”

The value of endocervical curettage after conization for cervical intraepithelial neoplasia

“…Lu et al (9) found incidences for residual disease in 56.5% of patients over 50 years and in 29.3% of patients younger than fifty years. An explanation for the results could be the fact that the transformation zone in older women is retracted into the endocervical canal (deep inversion) and that a progressive atrophy of the genital tract occurs in elder women (4,(7)(8)(9)(10). The sensitivity of ECC for residual CIN and/or carcinoma is low in both age groups,, 0.35 and 0.44, respectively, whereas sensitivity of a positive endocervical margin status of the cone is higher in both groups, 0.79 and 0.69, respectively.…”

“…Endocervical margin and ECC were positive in 32% of the hysterectomy specimens with pathological histology, similar to the pathological ECC alone (38%). Lu et al (9) found pathological hysterectomy specimens in 64.6% (31 patients) when the preceding ECC was positive and pathological findings in the hysterectomy in 46.9% (38 patients) when the endocervical margin was involved. When the ECC and the endocervical margins were involved, they found an incidence of residual disease in 71.4%.…”