Factors Predicting Residual Disease in Women with a Subsequent Hysterectomy Following the Loop Electrosurgical Excision Procedure for Cervical Intraepithelial Neoplasia at Uttaradit Hospital
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Abstract
BACKGROUND: Women who had residual disease left on their cervix after an initial cervical loop electrosurgical excision procedure carried a risk of recurrence or invasive cervical carcinoma progression. The study of the factors predicting the risk of residual lesions was therefore important for treatment.
OBJECTIVES: The study aimed to find the incidence and factors predicting residual disease in women with a subsequent hysterectomy following a loop electrosurgical excision procedure (LEEP) for cervical intraepithelial neoplasia at Uttaradit Hospital, Uttaradit Province, Thailand.
METHODS: This retrospective cohort study was under-taken by women with histology in a subsequent hysterectomy following the LEEP for cervical Intraepithelial neoplasia at Uttaradit Hospital during January 2014-March 2021. The research criteria were women who still had cervical intraepithelial neoplasia on the cervix within six weeks-12 months after treatment and had indications for a hysterectomy, including positive surgical margins following the LEEP that could not be a resection, or no cervical intraepithelial neoplasia but had indications of gynecological disease. The comparison group was those who had no lesions. The data were analyzed using descriptive statistics, Mantel-Jaenzel Chi-square test, and binary logistic regression.
RESULTS: One hundred and fifty-six women were included; residual disease was found in 56 women (35.9%). The factors predicting residual disease in a subsequent hysterectomy following the LEEP, included having endocervical margin involvement, aged ≥45 years, and had stromal invasion; with 94.2% of correct prediction.
CONCLUSIONS: Residual disease was found in 35.9% of the subsequent hysterectomy following the LEEP for cervical intraepithelial neoplasia, and the factors predicting the residual disease were at an acceptable level of accuracy in this study, which could be beneficial for appropriate management decision-making.
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