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BioMed Research International
Volume 2015, Article ID 984528, 8 pages
http://dx.doi.org/10.1155/2015/984528
Clinical Study

Long-Term Clinical Outcome after Treatment for High-Grade Cervical Lesions: A Retrospective Monoinstitutional Cohort Study

1Immunology and Molecular Oncology Unit, Veneto Institute of Oncology-(IOV-) IRCCS, Via Gattamelata 64, 35128 Padua, Italy
2Department of Woman and Child Health, Azienda Ospedaliera di Padova, Via Giustiniani 2, 35128 Padua, Italy
3Department of Pathology, Azienda Ospedaliera di Padova, Via Gabelli, 35121 Padua, Italy
4Veneto Tumour Registry, Passaggio Gaudenzio 1, 35131 Padua, Italy
5Department of Surgery, Oncology and Gastroenterology, University of Padua, 35128 Padua, Italy

Received 8 August 2014; Revised 5 December 2014; Accepted 10 March 2015

Academic Editor: Walter Prendiville

Copyright © 2015 Annarosa Del Mistro et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. The aim of this retrospective observational study of women treated for cervical intraepithelial neoplasia grade 2 or worse (CIN2+) was to assess the long-term risk of residual/recurrent high-grade CIN. Materials and Methods. We evaluated 760 women treated by loop electrosurgical excision procedure (684) or conization (76) between 2000 and 2009, and followed up to June 30, 2014 (median follow-up 6.7 years, range 4–14). Visits every 6 months for the first year after treatment and yearly for up to the following 10 years included cytology, colposcopy when indicated, and HPV testing (search and typing). Results. CIN2+ or vaginal intraepithelial neoplasia grade 2 or worse (VAIN2+) was detected in 67 cases (8.8%), 39 at first follow-up and 28 after one/more negative visits. The risk of CIN2+ was higher in case of positive margins (odds ratio (OR) 8.04, 95% CI 4.31–15.0), type 3 transformation zone (OR for CIN3 27.7, 95% CI 2.07–36.9), CIN3+ excision (OR 6.02, 95% CI 1.73–20.9), and positive high-risk HPV test at first follow-up (OR for HPV16: 20.6, 95% CI 6.8–62.6; OR for other hrHPV types: 18.3, 95% CI 5.9–57.0). Conclusion. Residual/recurrent high-grade CIN occurred in <9% cases, and the risk was associated with transformation zone type, lesion grade, margins status, and hrHPV test result at 6–12 months of follow-up.