Rosario Lara-Peñaranda1,2, Pilar M Rodríguez-López2, Javier Plitt-Stevens3, Ana Ortiz-González4, Manuel Remezal-Solano1,5, Juan P Martínez-Cendán1,2. 1. Deptartment of Medicine, Faculty of Health Sciences, Universidad Católica San Antonio de Murcia (UCAM), Murcia, Spain. 2. Department of Obstetrics and Gynecology, Hospital Universitario Santa Lucía, Cartagena, Spain. 3. Department of Tourism, Universidad Católica San Antonio de Murcia (UCAM), Murcia, Spain. 4. Department of Pathological Anatomy, Hospital Universitario Santa Lucía, Cartagena, Spain. 5. Department of Obstetrics and Gynecology, Oncology Unit of the Hospital Universitario Virgen de la Arrixaca, Murcia, Spain.
Abstract
OBJECTIVE: To analyze the relationship between large loop excision of the transformation zone (LLETZ) depth and the persistence of disease and human papillomavirus (HPV) infection in patients with cervical intraepithelial neoplasia grades 2 and 3. METHODS: A cross-sectional observational retrospective study included women with cervical intraepithelial neoplasia grades 2 and 3 who underwent LLETZ at Hospital Universitario Santa Lucía, Cartagena, Spain, from November 1, 2011, to December 31, 2016. Follow-up of cytology and HPV detection were performed at 6 and 12-18 months after surgery. RESULTS: In this study of 256 women, multivariate analysis revealed that conization depth of 10 mm or less did not indicate an increase of persistence/recurrence of pathological cytology at 6 months (P=0.094) and after 12-18 months (P=0.234), or infection by HPV at 6 months (P=0.675) and 12-18 months (P=0.938) after LLETZ. The affected endocervical margin at 6 months is the sole independent risk factor for persistence, both in the lesion (P=0.003) and HPV (P=0.004). CONCLUSION: Conization depth lower than 10 mm at LLETZ did not increase disease persistence or infection by HPV in an 18 month monitoring period. Therefore, higher depth conizations would not be justified to ensure favorable oncological results.
OBJECTIVE: To analyze the relationship between large loop excision of the transformation zone (LLETZ) depth and the persistence of disease and human papillomavirus (HPV) infection in patients with cervical intraepithelial neoplasia grades 2 and 3. METHODS: A cross-sectional observational retrospective study included women with cervical intraepithelial neoplasia grades 2 and 3 who underwent LLETZ at Hospital Universitario Santa Lucía, Cartagena, Spain, from November 1, 2011, to December 31, 2016. Follow-up of cytology and HPV detection were performed at 6 and 12-18 months after surgery. RESULTS: In this study of 256 women, multivariate analysis revealed that conization depth of 10 mm or less did not indicate an increase of persistence/recurrence of pathological cytology at 6 months (P=0.094) and after 12-18 months (P=0.234), or infection by HPV at 6 months (P=0.675) and 12-18 months (P=0.938) after LLETZ. The affected endocervical margin at 6 months is the sole independent risk factor for persistence, both in the lesion (P=0.003) and HPV (P=0.004). CONCLUSION: Conization depth lower than 10 mm at LLETZ did not increase disease persistence or infection by HPV in an 18 month monitoring period. Therefore, higher depth conizations would not be justified to ensure favorable oncological results.
Keywords:
Cervical intraepithelial neoplasia (CIN); Conization depth; Disease persistence; HPV persistence; Large loop excision of the transformation zone (LLETZ)
Authors: Nae Ry Kim; Zee Hae Baek; A Jin Lee; Eun Jung Yang; Yung-Taek Ouh; Mi Kyung Kim; Seung-Hyuk Shim; Sun Joo Lee; Tae Jin Kim; Kyeong A So Journal: J Clin Med Date: 2022-05-25 Impact factor: 4.964