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Does the trend toward less deep excisions in LLETZ to minimize obstetric risk lead to less favorable oncological outcomes?
Author(s) -
LaraPeñaranda Rosario,
RodríguezLópez Pilar M.,
PlittStevens Javier,
OrtizGonzález Ana,
RemezalSolano Manuel,
MartínezCendán Juan P.
Publication year - 2020
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1002/ijgo.13080
Subject(s) - medicine , lead (geology) , obstetrics , geology , geomorphology
Objective To analyze the relationship between large loop excision of the transformation zone (LLETZ) depth and the persistence of disease and human papillomavirus (HPV) infection in patients with cervical intraepithelial neoplasia grades 2 and 3. Methods A cross‐sectional observational retrospective study included women with cervical intraepithelial neoplasia grades 2 and 3 who underwent LLETZ at Hospital Universitario Santa Lucía, Cartagena, Spain, from November 1, 2011, to December 31, 2016. Follow‐up of cytology and HPV detection were performed at 6 and 12–18 months after surgery. Results In this study of 256 women, multivariate analysis revealed that conization depth of 10 mm or less did not indicate an increase of persistence/recurrence of pathological cytology at 6 months ( P =0.094) and after 12–18 months ( P =0.234), or infection by HPV at 6 months ( P =0.675) and 12–18 months ( P =0.938) after LLETZ. The affected endocervical margin at 6 months is the sole independent risk factor for persistence, both in the lesion ( P =0.003) and HPV ( P =0.004). Conclusion Conization depth lower than 10 mm at LLETZ did not increase disease persistence or infection by HPV in an 18 month monitoring period. Therefore, higher depth conizations would not be justified to ensure favorable oncological results.