Residual disease and risk factors in patients with high-grade cervical intraepithelial neoplasia and positive margins after initial conization

Abstract

Background

The purpose of this study was to determine the clinicopathologic predictors of residual disease in patients with high-grade cervical intraepithelial neoplasia (CIN) and margin involvement after initial conization.

Methods

Data from 145 patients who underwent subsequent surgery for high-grade CIN with positive margins were retrospectively analyzed.

Results

After subsequent surgery, residual disease was diagnosed in 47 (34.2%) patients, of whom five had invasive cervical carcinoma, 31 had CIN 3, nine had CIN 2, and two had CIN 1. Multivariate analysis revealed that only age ≥35 years (P=0.033), major abnormal cytology (P=0.002), and pre-cone high-risk human papillomavirus load ≥300 relative light units (P=0.011) were significant factors associated with residual disease.

Conclusion

Age ≥35 years, major abnormal cytology, and pre-cone high-risk human papillomavirus load ≥300 relative light units were the only significant factors predicting post-cone residual disease. Appropriate application of these predictive factors may avoid delayed treatment and overtreatment.

Keywords:

• cervical intraepithelial neoplasia
• residual disease
• conization
• positive margin
• predictor

Acknowledgments

This work was supported by the Foundation of Science and Technology Department of Zhejiang Province, People’s Republic of China (2012C13019-3, N20130174) and Special Fund for Scientific Research in the Public Interest from the National Health and Family Planning Commission of the People’s Republic of China (201402010).

Disclosure

The authors report no conflicts of interest in this work.