The risk factors of residual disease after conization.

Jeong, Sun Young; Lee, Hyun Jeong; Ku, Nam Sik; Oh, Sae Jeong; Hwang, Seong Jin; Bae, Seog Nyeon

Obstet Gynecol Sci > Volume 45(11); 2002 > Article

Original Article

Korean Journal of Obstetrics & Gynecology 2002;45(11):1940-1945.
Published online: November 1, 2002

The risk factors of residual disease after conization.

Sun Young Jeong, Hyun Jeong Lee, Nam Sik Ku, Sae Jeong Oh, Seong Jin Hwang, Seog Nyeon Bae

Department of Obstetrics and Gynecology, College of Medicine, Catholic university, Seoul, Korea.

Abstract

OBJECTIVE
Conization is used for diagnosis and treatment of cervical neoplasia. Our purpose of this investigation is to determine the efficacy of loop conization for the treatment of cervical dysplasia and the significance of the clinical and histological factors used to predict residual dysplasia after loop conization. METHODS: We reviewed the charts of patients who were received conization and subsequently total hysterectomy at Kangnam St Mary Hospital during 1989 and 2000. Logistic regression and Chi-square test were used for analysis. RESULTS: Total 257 patients were included. The mean age of the patients was 44.7 years. Of these patients, 87 (33.8%) had residual disease in the hysterectomy specimens. Age, the involvement of cut surface of endocervix and exocervix, severity and extent of the lesion, and scattering lesion were associated with the residual disease. But preoperative HPV infection, which is known as the cause of cervical neoplasia was not associated with the residual disease. CONCLUSION: When the high risk factors are present, the validity of conservative treatment should be considered and more careful follow up with pap smear, HPV test and colposcopy is necessary. Because about one thirds of patient has residual disease after conization, LEEP conization should be used for diagnosis of cervical neoplasia rather than treatment.

Keywords: Conization; Cervical neoplasia; Residual disease; Total hysterectomy; Risk factors