Risk factors related to recurrence after surgical excision procedure for cervical dysplasia.

Abstract

Background: This study aimed to identify the risk factors of recurrence following surgical excisional procedures for cervical intraepithelial lesions (CIN).

Methods: We conducted a retrospective cohort study of women with cervical pathology treated surgically over seven years. All patients with surgical interventions of the cervix were recorded and analyzed according to the recurrence following their primary treatment. We utilized the Chi-square test and the multivariate regression analysis to identify recurrence risk factors. We also employed the Kaplan-Meier survival analysis for disease recurrence.

Results: In total, 83 patients were reported; 81 (97.6 %) were treated with loop electrosurgical excision, and two (2.4 %) with cold knife conization. The histopathological results of the treatment approach showed one case (1.2 %) of low-grade intraepithelial lesions, 70 (84.4 %) high-grade intraepithelial lesions (HSIL), five (6 %) with IA1, and two (2.4 %) with IA2, cervical cancer, while in five patients (6 %) the results were negative for cervical pathology. Recurrence was diagnosed in 23 cases (27.7 %), and HSIL was diagnosed in 10 patients (12 %). The median time of recurrence was 11.6 months. Positive endocervical margins [odds ratio (OR): 52.478; 95 % confidence interval (CI): 8.315-331.203; p <0.001], excision of the cone in multiple specimens (OR: 8.793; 95 % CI: 1.854-41.693; p =0.006), and depth of cone less than one cm (OR: 21.225; 95 % CI: 3.176-141.863; p =0.002) were identified as independent risk factors for recurrence.

Conclusions: Positive endocervical margins, multiple loop passes, and depth of the cone less than one cm were the most significant risk factors for recurrence. HIPPOKRATIA 2023, 27 (4):132-140.