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Risk factors predicting residual disease in subsequent hysterectomy following conization for cervical intraepithelial neoplasia (CIN) III and microinvasive cervical cancer.
Gynecol Oncol 2007; 107(1):39-44GO

Abstract

OBJECTIVE

To determine factors predicting post-cone residual disease in cervical intraepithelial neoplasia (CIN) III and microinvasive cervical cancer.

METHODS

Of 337 patients who underwent conization due to CIN III and microinvasive cervical cancer between November 2001 and March 2006, 77 underwent hysterectomy within 6 months of conization. We analyzed their demographic features, pathologic parameters and pre-cone high-risk human papilloma virus (HR-HPV) load measured by Digene Hybrid Capture II.

RESULTS

In univariate analysis, age >or=50 years (P=0.048, relative risk [RR]=2.74, 95% confidence interval [CI]=1.0-7.4), positive resection margin (P=0.004, RR=4.35, 95% CI=1.5-12.3), and pre-cone HR-HPV load >or=300 relative light units (RLU)/positive control (PC) (P=0.009, RR=3.41, 95% CI=1.3-8.7) were significant factors associated with residual disease. While postmenopausal status showed borderline significance (P=0.065, RR=2.65, 95% CI=0.9-7.5), parity >or=3, severity of disease (CIN III vs. microinvasive cancer), conization method (large loop excision of transformation zone vs. cold knife conization), and glandular extension were not significant. In multivariate analysis only positive margin (P=0.023, RR=3.56, 95% CI=1.2-10.7) and pre-cone HR-HPV load >or=300 RLU/PC (P=0.034, RR=2.96, 95% CI=1.1-8.1) were significant factors associated with residual disease.

CONCLUSION

Positive margin and pre-cone HR-HPV load >or=300 RLU/PC were the only significant factors predicting post-cone residual disease in multivariate analysis. Appropriate application of these predictive factors may avoid post-cone hysterectomy.

Authors+Show Affiliations

Center for Uterine Cancer, Research Institute and Hospital, National Cancer Center, 809 Madu1-dong, Ilsan-gu, Goyang-si, Gyeonggi-do, 411-351, Korea.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

17582476

Citation

Park, Jeong-Yeol, et al. "Risk Factors Predicting Residual Disease in Subsequent Hysterectomy Following Conization for Cervical Intraepithelial Neoplasia (CIN) III and Microinvasive Cervical Cancer." Gynecologic Oncology, vol. 107, no. 1, 2007, pp. 39-44.
Park JY, Lee SM, Yoo CW, et al. Risk factors predicting residual disease in subsequent hysterectomy following conization for cervical intraepithelial neoplasia (CIN) III and microinvasive cervical cancer. Gynecol Oncol. 2007;107(1):39-44.
Park, J. Y., Lee, S. M., Yoo, C. W., Kang, S., Park, S. Y., & Seo, S. S. (2007). Risk factors predicting residual disease in subsequent hysterectomy following conization for cervical intraepithelial neoplasia (CIN) III and microinvasive cervical cancer. Gynecologic Oncology, 107(1), pp. 39-44.
Park JY, et al. Risk Factors Predicting Residual Disease in Subsequent Hysterectomy Following Conization for Cervical Intraepithelial Neoplasia (CIN) III and Microinvasive Cervical Cancer. Gynecol Oncol. 2007;107(1):39-44. PubMed PMID: 17582476.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Risk factors predicting residual disease in subsequent hysterectomy following conization for cervical intraepithelial neoplasia (CIN) III and microinvasive cervical cancer. AU - Park,Jeong-Yeol, AU - Lee,Seung Mi, AU - Yoo,Chong Woo, AU - Kang,Sokbom, AU - Park,Sang-Yoon, AU - Seo,Sang-Soo, Y1 - 2007/06/19/ PY - 2007/02/02/received PY - 2007/05/09/revised PY - 2007/05/14/accepted PY - 2007/6/22/pubmed PY - 2007/12/6/medline PY - 2007/6/22/entrez SP - 39 EP - 44 JF - Gynecologic oncology JO - Gynecol. Oncol. VL - 107 IS - 1 N2 - OBJECTIVE: To determine factors predicting post-cone residual disease in cervical intraepithelial neoplasia (CIN) III and microinvasive cervical cancer. METHODS: Of 337 patients who underwent conization due to CIN III and microinvasive cervical cancer between November 2001 and March 2006, 77 underwent hysterectomy within 6 months of conization. We analyzed their demographic features, pathologic parameters and pre-cone high-risk human papilloma virus (HR-HPV) load measured by Digene Hybrid Capture II. RESULTS: In univariate analysis, age >or=50 years (P=0.048, relative risk [RR]=2.74, 95% confidence interval [CI]=1.0-7.4), positive resection margin (P=0.004, RR=4.35, 95% CI=1.5-12.3), and pre-cone HR-HPV load >or=300 relative light units (RLU)/positive control (PC) (P=0.009, RR=3.41, 95% CI=1.3-8.7) were significant factors associated with residual disease. While postmenopausal status showed borderline significance (P=0.065, RR=2.65, 95% CI=0.9-7.5), parity >or=3, severity of disease (CIN III vs. microinvasive cancer), conization method (large loop excision of transformation zone vs. cold knife conization), and glandular extension were not significant. In multivariate analysis only positive margin (P=0.023, RR=3.56, 95% CI=1.2-10.7) and pre-cone HR-HPV load >or=300 RLU/PC (P=0.034, RR=2.96, 95% CI=1.1-8.1) were significant factors associated with residual disease. CONCLUSION: Positive margin and pre-cone HR-HPV load >or=300 RLU/PC were the only significant factors predicting post-cone residual disease in multivariate analysis. Appropriate application of these predictive factors may avoid post-cone hysterectomy. SN - 0090-8258 UR - https://www.unboundmedicine.com/medline/citation/17582476/Risk_factors_predicting_residual_disease_in_subsequent_hysterectomy_following_conization_for_cervical_intraepithelial_neoplasia__CIN__III_and_microinvasive_cervical_cancer_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0090-8258(07)00354-X DB - PRIME DP - Unbound Medicine ER -