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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

References

  1. Apgar BS, Kaufman AJ, Bettcher C, Parker-Featherstone E (2013). Gynecologic procedures: colposcopy, treatments for cervical intraepithelial neoplasia and endometrial assessment. Am Fam Physician, 87, 836-43.
  2. Diakomanolis E, Haidopoulos D, Chatzipapas I, et al (2003). Negative cone biopsies. A reappraisal. J Reprod Med, 48,617-21.
  3. Golbang P, Scurry J, De Jong S, et al (1997). Investigation of 100 consecutive negative cone biopsies. Br J Obstet Gynaecol,104, 100-4. https://doi.org/10.1111/j.1471-0528.1997.tb10658.x
  4. Jancar N, Rakar S, Poljak M, et al (2006). Efficiency of three surgical procedures in eliminating high-risk human papillomavirus infection in women with precancerous cervical lesions. Eur J Gynaecol Oncol, 27, 239-42.
  5. Jemal A, Bray F, Center MM, et al (2011). Global cancer statistics. CA Cancer J Clin, 61, 69-90. https://doi.org/10.3322/caac.20107
  6. Koc N, Sahin D, Ayas S (2013). Reevaluation of negative cone biopsy results after a positive cervical biopsy finding. J Low Genit Tract Dis, 17, 154-9. https://doi.org/10.1097/LGT.0b013e31825c33f9
  7. Montz FJ (2000). Management of high-grade cervical intraepithelial neoplasia and low-grade squamous intraepithelial lesion and potential complications. Clin Obstet Gynecol, 43, 394-409. https://doi.org/10.1097/00003081-200006000-00018
  8. Murta EF, Silva AO, Silva EA (2006). Clinical significance of a negative loop electrosurgical excision procedure, conization and hysterectomy for cervical intraepithelial neoplasia. Eur J Gynaecol Oncol, 27, 50-2.
  9. Rodriguez-Manfredi A, Alonso I, Del Pino M, et al (2013). Predictors of absence of cervical intraepithelial neoplasia in the conization specimen. Gynecol Oncol, 128, 271-6. https://doi.org/10.1016/j.ygyno.2012.10.020
  10. Vink MA, Bogaards JA, Van Kemenade FJ, et al (2013). Clinical progression of high-grade cervical intraepithelial neoplasia: estimating the time to preclinical cervical cancer from doubly censored national registry data. Am J Epidemiol, [Epub ahead of print].
  11. Weigl G, Pokieser W, Schuller B, et al (2006). Investigation of 208 consecutive cases of cervical cone biopsies with regard to indication, negative samples and quality control. Acta Cytol, 50, 185-90. https://doi.org/10.1159/000325929

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