Cervical intraepithelial neoplasia outcomes after treatment with cervical excisional procedures

O. Akbayir, O. Kuru, P. Goksedef, C. Numanoglu, A. Corbacioglu, H. Guraslan, M. Sakinci

Abstract: The aim of this study is the exploration of persistence/recurrence rate of cervical intraepithelial neoplasia (CIN) after treatment by cervical excisional procedures and to further investigate factors associated with disease. Medical and pathologic records of a number of 509 women during the period from January 2001 to March 2011, who underwent loop electrosurgical excision procedure or cold-knife conization, were taken into study. Multivariate logistic regression was performed to identify independent risk factors associated with persistent/recurrent CIN. From 49 of the patients (9.6%) who had histological recurrent/persistent disease, CIN 1, CIN 2, and CIN 3/CIS were detected in 44.8%, 12% and 42% of the patients. A multivariable analysis showed that high-grade lesion (CIN 2 or CIN 3) and positive margin status at initial diagnosis were significant independent factors for recurrent/residual disease. Patients who had incompletely excised high-grade lesion on initial conization specimen, had high risk of recurrent/persistent disease. Thus, re-treatment of this group should be considered. The patients with low-risk of recurrence/persistence constituted the majority (92%), and cytological surveillance of these women seems to be appropriate.
Keywords: cervical intraepithelial neoplasia, conization, persistence, recurrence