title: Human papillomavirus infection and the size and grade of cervical intraepithelial neoplastic lesions associated with failure of therapy.
abstract: OBJECTIVE
  This investigation was designed to identify specific risk factors associated with treatment failure for cervical intraepithelial neoplasia.
  
  
  METHODS
  A cohort of 436 women was assessed for the presence of cofactors associated with therapy failure. The risk factors included the HPV infection status of the patient, a previous history of genital condyloma and the size of cervical lesions.
  
  
  RESULTS
  The treatment outcome was not related to the treatment modality (P = 0.058). Thirteen (8.1%) women failed laser therapy, while 15 (5.4%) women failed cryotherapy. While treatment failure occurred only in the presence of HPV infection (P = 0.036), failure was not related to infection by a specific genotype. Therapy failure was associated with treatment for CIN II (RR 4.157) and CIN III (RR 2.053) relative to CIN I and treatment of large lesions (P = 0.014).
  
  
  CONCLUSIONS
  The determination of the relative area occupied by cervical lesions may have prognostic value in identifying women who are at risk for treatment failure.
authors.affiliation: Department of Obstetrics, Gynecology, University of Manitoba, Winnipeg, Canada.
authors.forename: F
authors.initials: F
authors.lastname: Guijon
authors.forename: M
authors.initials: M
authors.lastname: Paraskevas
authors.forename: P
authors.initials: P
authors.lastname: McNicol
mesh_terms: D000293:Adolescent; D000328:Adult; D015331:Cohort Studies; D017679:Cryotherapy; D005260:Female; D006801:Humans; D053685:Laser Therapy; D008875:Middle Aged; D027383:Papillomaviridae; D030361:Papillomavirus Infections / Q000150:complications*; D012307:Risk Factors; D013997:Time Factors; D017211:Treatment Failure; D014412:Tumor Virus Infections / Q000150:complications*; D002583:Uterine Cervical Neoplasms / Q000150:complications / Q000473:pathology / Q000628:therapy*; D002578:Uterine Cervical Dysplasia / Q000150:complications / Q000473:pathology / Q000628:therapy*