title: Predictors of recurrent/residual disease after loop electrosurgical excisional procedure.
abstract: OBJECTIVE
  The aim of this study was to identify predictors of recurrent/residual disease for management after loop electrosurgical excisional procedure.
  
  
  METHODS
  We retrospectively reviewed 178 patients with cervical intraepithelial neoplasia grade 3 and microinvasive squamous cell carcinoma who underwent the loop electrosurgical excisional procedure between April 2011 and March 2014. Endocervical/ectocervical margin status, endocervical curettage (ECC) status, and maximum width of cervical intraepithelial neoplasia were assessed. Patients were followed up for 6-12 months.
  
  
  RESULTS
  Patients with endocervical margin involvement were significantly older and those with ectocervical margin involvement were significantly younger than patients with no margin involvement (P = 0.02 for both comparisons). ECC-positive patients were significantly older than ECC-negative patients (P = 0.049). There was a significant difference in the mean width of the cervical intraepithelial neoplasia between women with ectocervical involvement and those without ecto- or endocervical involvement (10.2 ± 3.1 mm vs 7.3 ± 3.5 mm, P = 0.0002). The odds ratios for possible recurrent/residual disease for endocervical involvement, ectocervical involvement, and ECC-positivity were 2.1 (0.5-8.4), 3.2 (1.3-7.9), and 6.8 (1.4-32.1), respectively. However, while most ECC-positive patients underwent a second surgery, most patients with ectocervical involvement did not need further treatment.
  
  
  CONCLUSIONS
  Older age and ECC were significantly associated with endocervical margin involvement; younger age and width of cervical intraepithelial neoplasia were associated with ectocervical margin involvement. Ectocervical margin involvement significantly increased the risk of possible recurrent/residual disease; however, these patients might recover naturally. ECC-positivity significantly increased the risk of recurrent/residual disease.
authors.affiliation: Department of Obstetrics and Gynecology, Jichi Medical University, Saitama Medical Center, Saitama, Japan.
authors.forename: Kenro
authors.initials: K
authors.lastname: Chikazawa
authors.affiliation: Department of Obstetrics and Gynecology, Jichi Medical University, Saitama Medical Center, Saitama, Japan.
authors.forename: Sachiho
authors.initials: S
authors.lastname: Netsu
authors.affiliation: Department of Gynecology, Kyosai Hospital, Saitama, Japan.
authors.forename: Shigeru
authors.initials: S
authors.lastname: Motomatsu
authors.affiliation: Department of Obstetrics and Gynecology, Jichi Medical University, Saitama Medical Center, Saitama, Japan.
authors.forename: Ryo
authors.initials: R
authors.lastname: Konno
mesh_terms: D000328:Adult; D000367:Age Factors; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000601:surgery*; D002584:Cervix Uteri / Q000473:pathology; D004598:Electrosurgery / Q000379:methods*; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D000072662:Margins of Excision; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology*; D018365:Neoplasm, Residual / Q000453:epidemiology*; D012189:Retrospective Studies; D002583:Uterine Cervical Neoplasms / Q000473:pathology / Q000601:surgery*; D002578:Uterine Cervical Dysplasia / Q000473:pathology / Q000601:surgery*
keywords: cervical intraepithelial neoplasia; cervix uteri; curettage; recurrence; residual neoplasm