Predictive factors from cold knife conization for residual cervical intraepithelial neoplasia in subsequent hysterectomy

Moore, Barbara C.; Higgins, Robert V.; Laurent, Sherry L.; Marroum, Marie-Claire; Bellitt, Patricia

doi:10.1016/0002-9378(95)90253-8

Cited by 75 publications

(57 citation statements)

References 13 publications

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“…19,20 Older age has been shown to be a predictor for recurrence in other studies. 21 In contrast, our results showed that age was not related to recurrence. High HPV load before LEEP may also be associated with recurrent disease.…”

Section: Discussioncontrasting

confidence: 88%

Absence of dysplasia in the excised cervix by a loop electrosurgical excision procedure in the treatment of cervical intraepithelial neoplasia

et al. 2010

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Objective: Absence of dysplasia in the excised specimen following loop electrosurgical excision procedure (LEEP) for treatment of cervical intraepithelial neoplasia (CIN) 2/3 is an occasional finding of uncertain clinical significance. We evaluated several factors including age, liquid-based Pap (LBP) test, human papillomavirus (HPV) load before treatment, and HPV typing as predictors for absence of dysplasia. Absence of dysplasia in LEEP specimens was analyzed in terms of factors for recurrent disease after LEEP conization. Methods: In total, 192 women (mean age, 39.3±8.4 years; range, 24 to 70 years) with biopsy-proven CIN 2/3 were treated by LEEP conization. Age, LBP test, histological grade, HPV load, and HPV DNA typing were evaluated as possible predictors of the absence of residual dysplasia or recurrent disease. Results: Of the LEEP specimens, 34 (17.7%) showed no dysplasia in preoperative biopsies from patients with proven CIN 2/3. Low HPV load (＜100 relative light units [RLU]) was significantly related to the absence of dysplasia in LEEP specimens, using logistic regression. Margin involvement and high HPV load (≥400 RLU) were significant factors for recurrence. Conclusion: Absence of dysplasia in LEEP specimens occurred in 17.7% of our specimens. Prediction of the absence of dysplasia in LEEP specimens was associated with low HPV load. Residual/recurrent disease after LEEP was associated with a positive resection margin and high viral load, and was not associated with absence of dysplasia in LEEP specimens. Even if there is no dysplasia in conization specimens, close follow-up for residual/recurrent disease is needed.

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Section: Discussioncontrasting

confidence: 88%

Absence of dysplasia in the excised cervix by a loop electrosurgical excision procedure in the treatment of cervical intraepithelial neoplasia

et al. 2010

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“…It is concordant wih previously reported results which were as high as 40% (15). Although there are some speculations for margin positivity to increase future recurrent/residual disease, common opinion supports monitorization other than re-excision (16,17). We did not perform repeated LEEP to any patients because of surgical margin positivity, but paid attention to make first control visit in six months' time.…”

Section: Discussionsupporting

confidence: 88%

Determination of Recurrent/Residual Cin-Ii and Cin-Iii After Leep. Cytology or HPV-Dna?

Çoban

Durukan

Dilek

et al. 2016

ZKTB

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“…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.…”

Section: Introductionmentioning

confidence: 99%

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

Bae

Lim

et al. 2009

J Gynecol Oncol

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Objective: To examine whether the presence of high risk-human papilloma virus (HR-HPV) after conization of the cervix was a risk factor for persistence or recurrence of cervical intraepithelial neoplasia (CIN) and whether HR-HPV test could be a guideline for post-therapy surveillance. Methods:The study retrospectively analyzed data from 243 patients who underwent LLETZ or CKC of the cervix due to CIN. Results: A positive HR-HPV test result which was performed between 3 and 6 months after procedure was a risk factor for persistent or recurrent cytological (p＜0.001, odds ratio [OR]=22.51, 95% confidence interval [CI]= 9.74-52.02) and pathological (p＜0.001, OR=18.28, 95% CI=5.55-60.20) abnormalities. Conclusion: HR-HPV positive patients between 3 and 6 months after procedure should undergo frequent and meticulous post-therapy surveillance, while HR-HPV negative patients do not require such high-level surveillance and could undergo routine surveillance.

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Predictive factors from cold knife conization for residual cervical intraepithelial neoplasia in subsequent hysterectomy

Cited by 75 publications

References 13 publications

Absence of dysplasia in the excised cervix by a loop electrosurgical excision procedure in the treatment of cervical intraepithelial neoplasia

Absence of dysplasia in the excised cervix by a loop electrosurgical excision procedure in the treatment of cervical intraepithelial neoplasia

Determination of Recurrent/Residual Cin-Ii and Cin-Iii After Leep. Cytology or HPV-Dna?

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

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