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Predictors for recurrent/persistent high-grade intraepithelial lesions and cervical stenosis after therapeutic conization: a retrospective analysis of 522 cases

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Abstract

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.

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Acknowledgements

We thank Dr. G.S. Buzard for his constructive critique and editing of our manuscript.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan

    Yusuke Tanaka, Yutaka Ueda, Mamoru Kakuda, Satoshi Kubota, Satoko Matsuzaki, Tadashi Iwamiya, Akiko Okazawa, Shinya Matsuzaki, Kae Hashimoto, Eiji Kobayashi, Seiji Mabuchi, Kenjiro Sawada, Takuji Tomimatsu, Kiyoshi Yoshino & Tadashi Kimura

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  1. Yusuke Tanaka
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  2. Yutaka Ueda
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  3. Mamoru Kakuda
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  4. Satoshi Kubota
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  5. Satoko Matsuzaki
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  6. Tadashi Iwamiya
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  8. Shinya Matsuzaki
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  9. Kae Hashimoto
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  13. Takuji Tomimatsu
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  14. Kiyoshi Yoshino
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  15. Tadashi Kimura
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Corresponding author

Correspondence to Yutaka Ueda.

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The authors declare no conflict of interest.

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Tanaka, Y., Ueda, Y., Kakuda, M. et al. Predictors for recurrent/persistent high-grade intraepithelial lesions and cervical stenosis after therapeutic conization: a retrospective analysis of 522 cases. Int J Clin Oncol 22, 921–926 (2017). https://doi.org/10.1007/s10147-017-1124-z

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  • DOI: https://doi.org/10.1007/s10147-017-1124-z

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