Details

Autor(en) / Beteiligte

• BOGANI, Giorgio
• DI DONATO, Violante
• SOPRACORDEVOLE, Francesco
• CIAVATTINI, Andrea
• GHELARDI, Alessandro
• LOPEZ, Salvatore
• SIMONCINI, Tommaso
• PLOTTI, Francesco
• CASARIN, Jvan
• SERATI, Maurizio
• PINELLI, Ciro
• VALENTI, Gaetano
• BERGAMINI, Alice
• GARDELLA, Barbara
• DELL'ACQUA, Andrea
• MONTI, Ermelinda
• VERCELLINI, Paolo
• FISCHETTI, Margherita
• D'IPPOLITO, Giovanni
• AGUZZOLI, Lorenzo
• MANDATO, Vincenzo D.
• CARUNCHIO, Paola
• CARLINFANTE, Gabriele
• GIANNELLA, Luca
• SCAFFA, Cono
• FALCONE, Francesca
• BORGHI, Chiara
• DITTO, Antonino
• MALZONI, Mario
• GIANNINI, Andrea
• SALERNO, Maria Giovanna
• LIBERALE, Viola
• CONTINO, Biagio
• DONFRANCESCO, Cristina
• DESIATO, Michele
• PERRONE, Anna Myriam
• DONDI, Giulia
• De IACO, Pierandrea
• LEONE ROBERTI MAGGIORE, Umberto
• SIGNORELLI, Mauro
• CHIAPPA, Valentina
• FERRERO, Simone
• SARPIETRO, Giuseppe
• MATARAZZO, Maria G.
• CIANCI, Antonio
• BOSIO, Sara
• RUISI, Simona
• GUERRISI, Rocco
• BRUSADELLI, Claudia
• MOSCA, Lavinia
• TINELLI, Raffaele
• DE VINCENZO, Rosa
• ZANNONI, Gian Franco
• FERRANDINA, Gabriella
• PETRILLO, Marco
• DESSOLE, Salvatore
• ANGIOLI, Roberto
• GREGGI, Stefano
• SPINILLO, Arsenio
• GHEZZI, Fabio
• COLACURCI, Nicola
• MUZII, Ludovico
• BENEDETTI PANICI, Pierluigi
• SCAMBIA, Giovanni
• RASPAGLIESI, Francesco

Titel

Recurrence rate after loop electrosurgical excision procedure (LEEP) and laser Conization: A 5-year follow-up study

Ist Teil von

• Gynecologic oncology, 2020-12, Vol.159 (3), p.636-641

Ort / Verlag

United States: Elsevier Inc

Erscheinungsjahr

2020

Quelle

MEDLINE

Beschreibungen/Notizen

• Conization aims to remove pre-neoplastic lesions of the uterine cervix. Several techniques for conization have been compared, but evidence regarding the most effective therapeutic option is scant. Here, we aimed to compare the recurrence rate following laser conization and loop electrosurgical excision procedure (LEEP) in patients with high-grade cervical dysplasia (HSIL/CIN2+). This is a retrospective multi-institutional study. Medical records of consecutive patients with HSIL/CIN2+ undergoing conization between 2010 and 2014 were retrieved. A propensity-score matching (PSM) was applied in order to reduce allocation bias. The risk of developing recurrence was estimated using Kaplan-Meir and Cox hazard models. Overall, 2966 patients had conization over the study period, including 567 (20%) and 2399 (80%) patients having laser conization and LEEP, respectively. Looking at predictors of recurrence, diagnosis of CIN3 (HR:3.80 (95%CI:2.01,7.21); p < 0.001) and HPV persistence (HR:1.81 (95%CI:1.11,2.96); p < 0.001) correlated with an increased risk of recurrence. After applying a PSM we selected 500 patients undergoing laser conization and 1000 undergoing LEEP. Patients undergoing LEEP were at higher risk of having positive surgical margins in comparison to patients undergoing laser conization (11.2% vs. 4.2%). The risk of having persistence of HPV was similar between the two groups (15.0% vs. 11.6%;p = 0.256). Five-year recurrence rate was 8.1% and 4% after LEEP and laser conization, respectively (p = 0.023). HPV persistence was the only factor associated with [5-]year recurrence after both laser conization (p = 0.003) and LEEP (p = 0.001). HPV persistence is the only factor associated with an increased risk of recurrence after either laser conization or LEEP. Owing to the lack of data regarding obstetrical outcomes, we are not able to assess the best therapeutic option for women with cervical dysplasia. [Display omitted] •HPV persistence correlates with an increased risk of [5-]year recurrence in women undergoing cervical conization•Patients undergoing laser conization experience a slightly lower risk of recurrence in comparison to LEEP•Further evidence regarding fertility and obstetrical issues is necessary