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Clinical Outcomes of Cases with Absent Cervical Dysplasia in Cold Knife Conization Specimens

  • Baser, Eralp (Department of Gynecologic Oncology, Zekai Tahir Burak Women's Health Education and Research Hospital) ;
  • Ozgu, Emre (Department of Gynecologic Oncology, Zekai Tahir Burak Women's Health Education and Research Hospital) ;
  • Erkilinc, Selcuk (Department of Obstetrics and Gynecology, Zekai Tahir Burak Women's Health Education and Research Hospital) ;
  • Yalcin, Hakan (Department of Gynecologic Oncology, Zekai Tahir Burak Women's Health Education and Research Hospital) ;
  • Cetinkaya, Nilufer (Department of Gynecologic Oncology, Zekai Tahir Burak Women's Health Education and Research Hospital) ;
  • Sirvan, Levent (Department of Pathology, Zekai Tahir Burak Women's Health Education and Research Hospital) ;
  • Erkaya, Salim (Department of Obstetrics and Gynecology, Zekai Tahir Burak Women's Health Education and Research Hospital) ;
  • Gungor, Tayfun (Department of Gynecologic Oncology, Zekai Tahir Burak Women's Health Education and Research Hospital)
  • Published : 2013.11.30

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 $1^{st}$ 2008 and August $1^{st}$ 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.

Keywords

Cold knife conization;human papillomavirus;cervical intraepithelial neoplasia

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