Residual and recurrent lesions after conization for cervical intraepithelial neoplasia grade 3.
OBJECTIVE
To evaluate the importance of regular and long-term follow-up of patients who had conization for cervical intraepithelial neoplasia grade 3 (CIN 3); and to assess the risk of residual/recurrent lesions of the cervix uteri.


METHODS
Retrospective analysis of 934 patients with CIN 3 who underwent conization over the period 1 January 1985-31 December 1997. The analysis included 38 (4.1%) patients who had involved resection margins and 896 (95.9%) patients who had free resection margins.


RESULTS
Twenty-three out of 934 (2.5%) patients had another operation (reconization in 17 and hysterectomy in six) whereas one patient had a biopsy. Residual or recurrent lesion after conization was found in 23 patients out of 934 (2.5%). Three patients had invasive cervical cancer (0.3%), 19 had CIN 3 (2.0%) and one patient had CIN 1 (0.1%). One of the 24 patients (4.2%) was diagnosed with no lesion after repeated operation. Eleven patients out of 38 (28.9%) with involved resection margins during the first conization had residual/recurrent disease, compared with eight out of 896 patients (0.9%) who had free resection margins.


CONCLUSIONS
Another operation is recommended only in cases when, on the basis of cytological, colposcopical and histological findings, the gynecologist suspect the residual/recurrent lesions.
Milojkovic
M
M
Department of Gynecology and Obstetrics, Clinical Hospital Osijek, Osijek, Croatia. milojkovic_os@altavista.com
D002584:Cervix Uteri / Q000473:pathology / Q000601:surgery; D003127:Colposcopy; D019092:Conization; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D009364:Neoplasm Recurrence, Local / Q000473:pathology*; D018365:Neoplasm, Residual / Q000473:pathology*; D012189:Retrospective Studies; D018570:Risk Assessment; D013997:Time Factors; D002583:Uterine Cervical Neoplasms / Q000473:pathology* / Q000601:surgery*; D014626:Vaginal Smears; D002578:Uterine Cervical Dysplasia / Q000473:pathology* / Q000601:surgery*