Title |
Factors that influence persistence or recurrence of high-grade squamous intraepithelial lesion with positive margins after the loop electrosurgical excision procedure: a retrospective study
|
---|---|
Published in |
BMC Cancer, October 2015
|
DOI | 10.1186/s12885-015-1748-1 |
Pubmed ID | |
Authors |
Menghan Zhu, Yuan He, Jan PA Baak, Xianrong Zhou, Yuqing Qu, Long Sui, Weiwei Feng, Qing Wang |
Abstract |
In 5-20 % of patients with cervical high-grade squamous intraepithelial lesion (HSIL), a positive margin after the loop electrosurgical excision procedure (LEEP) is associated with persistence/recurrence, but the prognostic value of other clinico-pathological factors is less clear. Among 4336 patients with HSIL who underwent an initial LEEP, 275 (6 %) had HSIL-positive margins, 37 of whom were lost to follow-up. We evaluated the remaining 238 patients. Persistence/recurrence was defined as histopathological HSIL during follow-up. The age of the patients ranged from 21 to 69 years (median: 40). The median follow-up period was 25 months (range: 6-43). Of the 238 patients, 211 (88.7 %) patients remained free of persistence/recurrence, while 27 (11.3 %) experienced persistence/recurrence. According to a univariate analysis, age (P = 0.03) and maximum specimen diameter (P = 0.043) were associated with persistence/recurrence, but number/location of involved margin sections and the pathology of the endocervical curettage were not (P > 0.10). The relative risk of the subjects (greater than or equal to 35 years ages) was 4.6 times of the subject less than 35 years, the difference was statistically significant (14 % vs. 3 %, P < 0.05). A multivariate analysis indicated that an age of 35 years or older was the only independent risk factor (OR 4.97, 95 % CI 1.14-21.62, P = 0.03). In patients with HSIL and HSIL-involved margins after an initial LEEP, age is a strong independent predictor of persistence/recurrence. Follow-up with screening cytology and/or biopsy may be considered in younger patients, whereas a secondary LEEP/hysterectomy may be considered in older patients. |
Mendeley readers
Geographical breakdown
Country | Count | As % |
---|---|---|
Unknown | 56 | 100% |
Demographic breakdown
Readers by professional status | Count | As % |
---|---|---|
Student > Ph. D. Student | 8 | 14% |
Student > Master | 8 | 14% |
Student > Postgraduate | 5 | 9% |
Student > Bachelor | 4 | 7% |
Researcher | 4 | 7% |
Other | 8 | 14% |
Unknown | 19 | 34% |
Readers by discipline | Count | As % |
---|---|---|
Medicine and Dentistry | 22 | 39% |
Nursing and Health Professions | 2 | 4% |
Business, Management and Accounting | 2 | 4% |
Agricultural and Biological Sciences | 2 | 4% |
Immunology and Microbiology | 2 | 4% |
Other | 4 | 7% |
Unknown | 22 | 39% |