Clinical outcomes of cases with cervical dysplasia absent in cold knife conization specimens

Asian Pac J Cancer Prev. 2014 Jan;14(11):6693-6. doi: 10.7314/apjcp.2013.14.11.6693.

Abstract

Background: Cold knife conization is a surgical procedure that allows both diagnosis and treatment of cervical lesions at the same time. It is mainly performed for indications of high-grade cervical intraepithelial neoplasia (CIN). In this study, we aimed to investigate the clinical outcome of cases without CIN in cold knife conization specimen, following a high-grade lesion (CIN2/3) in cervical biopsy.

Materials and methods: We performed a retrospective cohort study at a tertiary referral hospital between January 1st 2008 and August 1st 2012. Cases that underwent cold knife conization for CIN2/3 within the study period were included. Cone-negative (Group 1) and cone-positive (Group 2) cases were analyzed for various clinical parameters, and were compared in the 1-year post-conization period for histological recurrence and human papillomavirus (HPV) DNA status.

Results: A total of 173 women underwent cold knife conization for CIN2/3 within the study period. Twenty-two cases (12.7%) were included in Group 1 and 151 cases (87.3%) in Group 2. There were no significant differences between the two groups in terms of age, gravidity, parity, menopausal status and HPV-DNA status (pre-conization and 1 year post-conization) (p>0.05). Recurrence rates were also similar between the groups (9.1% vs 9.9%, p>0.05).

Conclusions: Clinical outcomes were similar in terms of histological recurrence and HPV persistence after 1 year of follow-up between cone-negative and cone-positive cases. Clinical follow-up of cone-negative cases should therefore be performed similar to cone-positive cases.

MeSH terms

  • Adult
  • Carcinoma, Squamous Cell / pathology
  • Carcinoma, Squamous Cell / surgery*
  • Conization / methods*
  • Cryosurgery / methods*
  • Female
  • Follow-Up Studies
  • Humans
  • Neoplasm Recurrence, Local / diagnosis*
  • Neoplasm Staging
  • Prognosis
  • Retrospective Studies
  • Tertiary Care Centers
  • Uterine Cervical Dysplasia / pathology
  • Uterine Cervical Dysplasia / surgery*
  • Uterine Cervical Neoplasms / pathology
  • Uterine Cervical Neoplasms / surgery*