Risk factors for residual/recurrent cervical intraepithelial neoplasia after LEEP conization.

Tamuna Gogoladze; Vasil Tkeshelashvili; Tamar Alibegashvili

Volume : VII, Issue : XII, December - 2018

Risk factors for residual/recurrent cervical intraepithelial neoplasia after LEEP conization.

Tamuna Gogoladze, Vasil Tkeshelashvili, Tamar Alibegashvili

Abstract :

Background: The purpose of this study was to evaluate the efficacy of excisional treatment and determining the main risk factors for prediction of residual/recurrent disease in patients with high–grade cervical intraepithelial neoplasia.

Methods: We retrospectively analyzed 613 patients , who underwent excisional treatment of the cervix (LEEP) In Georgian national screening center (GNSC). Follow–up observation after the treatment was conducted ≥ 3 times, to 223 women during two years period, following the treatment. Follow–up was performed by Pap smear test, colposcopy and histamorphological examinations.

Results: Forty one (18.4%) of 223 patients had residual/recurrent lesion during follow–up. According to univariate analysis the patient’s age (p<0.01) OR 3.2 (95% CI 1.3–8.4), transformation zone type III (p<0.01) OR 5.0 (95%CI 2.1–11.5), endocervical gland involvement (p<0.01) OR 6.2 (95%CI 2.7 – 15.1 ), smoking status (p<0.001) OR 7.7 (95% CI 3.336–17.8), major abnormal cytology (p<0.05) OR 2.72 (95% CI 0.963–9.512) were significant risk factors for residual/recurrent disease. However, gravidity, parity, severity of disease and positive margins were not relevant factors for the residual/recurrent disease (P>0.05).

Conclusion: Patients with older age, glandular involvement, TZ type III, smokers should be identified for close surveillance and monitoring. Consideration and implementation of these predictive factors in patient surveillance protocol will allow avoiding delayed treatment or overtreatment.