Human papillomavirus infection and the size and grade of cervical intraepithelial neoplastic lesions associated with failure of therapy.
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.
Guijon
F
F
Department of Obstetrics, Gynecology, University of Manitoba, Winnipeg, Canada.
Paraskevas
M
M
McNicol
P
P
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*