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High‐risk human papillomavirus correlates with recurrence after laser ablation for treatment of patients with cervical intraepithelial neoplasia 3: A long‐term follow‐up retrospective study
Author(s) -
Inaba Kanako,
Nagasaka Kazunori,
Kawana Kei,
Arimoto Takahide,
Matsumoto Yoko,
Tsuruga Tetsushi,
MoriUchino Mayuyo,
Miura Shiho,
Sone Kenbun,
Oda Katsutoshi,
Nakagawa Shunsuke,
Yano Tetsu,
Kozuma Shiro,
Fujii Tomoyuki
Publication year - 2014
Publication title -
journal of obstetrics and gynaecology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 50
eISSN - 1447-0756
pISSN - 1341-8076
DOI - 10.1111/jog.12196
Subject(s) - medicine , cervical intraepithelial neoplasia , human papillomavirus , retrospective cohort study , ablation , oncology , cervical cancer , cancer
Aim The purpose of our study was to evaluate the efficacy of laser ablation as a conservative treatment for cervical intraepithelial neoplasia 3 ( CIN 3) and assess whether the human papillomavirus ( HPV ) test is useful to predict recurrence after treatment. Materials and Methods A total of 134 patients who received laser ablation for treatment of CIN 3 were enrolled in this study. During the follow‐up period, patients were followed with cytological and colposcopic evaluations. Recurrence of CIN 3 was regarded as the primary end‐point. HPV genotype was tested before and after treatment. Post‐treatment cumulative recurrence rates were estimated and comparisons by both patient age and HPV genotype were performed. Results Overall cumulative recurrence rate of CIN 3 in the first year after treatment was 22.6% for all patients. No significant correlation was shown between patient age and recurrence. Patients infected by specific genotypes (16, 18, 31, 33, 52, and 58) frequently failed to clear the infection after treatment. The 1‐year recurrence‐free survival in those positive after treatment for eight high‐risk genotypes (16, 18, 31, 33, 35, 45, 52, and 58) was significantly lower (66.7%), compared to that in those positive for other high‐risk types (78.6%). The recurrence‐free survival of those who remained HPV ‐positive after treatment was significantly lower than those who turned negative. Conclusion Laser ablation should be performed prudently with appropriate patient counseling about recurrence rate. Considering its minimal invasiveness, laser ablation is effective, especially for young patients who are negative for eight high‐risk genotypes. With regard to HPV testing, although genotyping has significant value for predicting recurrence, screening for all genotypes warrants further evaluation.