OBJECTIVE: The objective of the study is to identify the risk factors associated with recurrent/persistent disease and cervical stenosis after conization. METHODS: Five hundred twenty-two (522) cases of high-grade intraepithelial lesions treated by conization were retrospectively reviewed. Risk factors associated with recurrent/persistent disease were analyzed by univariate and multivariate analysis using a Cox hazard regression model. Factors that could potentially affect the risk of cervical stenosis were examined by univariate and by multivariate analysis using the χ 2 test and logistic regression, respectively. RESULTS: Recurrent/persistent diseases and cervical stenosis occurred in 4.8% and 5.4% of the patients, respectively. Age ≥46 years [hazard ratio (HR) 3.6, 95% CI 1.36-10.3, p = 0.0092] and surgical margin involvement (HR 13.44, 95% CI 5.07-46.37, p < 0.001) were independent predictors for recurrent/persistent diseases. Age ≥46 years [odds ratio (OR) 4.27, 95% CI 1.88-10.07, p < 0.001] and shortened interval after childbirth to conization (within 12 months) (OR 5.42, 95% CI 1.42-17.41, p = 0.016) were independent risk factors for cervical stenosis. CONCLUSION: Elderly patients (aged ≥46 years) are at high risk of recurrence and cervical stenosis, which may lead to unsatisfactory follow-up. Subsequent hysterectomy is beneficial to patients aged 46 or older with surgical margin involvement. Clinicians should recognize the possibility of cervical stenosis after conization during the breastfeeding period, leading to secondary infertility or hematometra.
OBJECTIVE: The objective of the study is to identify the risk factors associated with recurrent/persistent disease and cervical stenosis after conization. METHODS: Five hundred twenty-two (522) cases of high-grade intraepithelial lesions treated by conization were retrospectively reviewed. Risk factors associated with recurrent/persistent disease were analyzed by univariate and multivariate analysis using a Cox hazard regression model. Factors that could potentially affect the risk of cervical stenosis were examined by univariate and by multivariate analysis using the χ 2 test and logistic regression, respectively. RESULTS: Recurrent/persistent diseases and cervical stenosis occurred in 4.8% and 5.4% of the patients, respectively. Age ≥46 years [hazard ratio (HR) 3.6, 95% CI 1.36-10.3, p = 0.0092] and surgical margin involvement (HR 13.44, 95% CI 5.07-46.37, p < 0.001) were independent predictors for recurrent/persistent diseases. Age ≥46 years [odds ratio (OR) 4.27, 95% CI 1.88-10.07, p < 0.001] and shortened interval after childbirth to conization (within 12 months) (OR 5.42, 95% CI 1.42-17.41, p = 0.016) were independent risk factors for cervical stenosis. CONCLUSION: Elderly patients (aged ≥46 years) are at high risk of recurrence and cervical stenosis, which may lead to unsatisfactory follow-up. Subsequent hysterectomy is beneficial to patients aged 46 or older with surgical margin involvement. Clinicians should recognize the possibility of cervical stenosis after conization during the breastfeeding period, leading to secondary infertility or hematometra.
Authors: Jacob Bornstein; James Bentley; Peter Bösze; Frank Girardi; Hope Haefner; Michael Menton; Myriam Perrotta; Walter Prendiville; Peter Russell; Mario Sideri; Björn Strander; Silvio Tatti; Aureli Torne; Patrick Walker Journal: Obstet Gynecol Date: 2012-07 Impact factor: 7.661
Authors: O K Vintermyr; O Iversen; S Thoresen; W Quint; A Molijn; S de Souza; D Rosillon; K Holl Journal: Gynecol Oncol Date: 2014-03-11 Impact factor: 5.482
Authors: Diane Solomon; Diane Davey; Robert Kurman; Ann Moriarty; Dennis O'Connor; Marianne Prey; Stephen Raab; Mark Sherman; David Wilbur; Thomas Wright; Nancy Young Journal: JAMA Date: 2002-04-24 Impact factor: 56.272