Journal of South Asian Federation of Obstetrics and Gynaecology

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VOLUME 15 , ISSUE 4 ( July-August, 2023 ) > List of Articles

Original Article

Factors Predicting Recurrence of Cervical Intraepithelial Neoplasia after Excisional Procedure-A 10-year Experience from A Tertiary Care Center

Raji Pambinkavil, Anitha Thomas, Dhanya Susan Thomas, Vinotha Thomas, Rachel George Chandy, Sherin Daniel, Abraham Peedicayil, Ajit Sebastian

Keywords : Cervical intraepithelial neoplasia, Excisional procedure, Follow-up, hysterectomy, Recurrence

Citation Information : Pambinkavil R, Thomas A, Thomas DS, Thomas V, Chandy RG, Daniel S, Peedicayil A, Sebastian A. Factors Predicting Recurrence of Cervical Intraepithelial Neoplasia after Excisional Procedure-A 10-year Experience from A Tertiary Care Center. J South Asian Feder Obs Gynae 2023; 15 (4):404-408.

DOI: 10.5005/jp-journals-10006-2270

License: CC BY-NC 4.0

Published Online: 16-09-2023

Copyright Statement:  Copyright © 2023; The Author(s).


Aim: Cervical intraepithelial neoplasia (CIN) is a precancerous condition of the uterine cervix commonly encountered in clinical practice. Treatment of CIN is excisional or ablative. This study aims to elucidate and evaluate the possible risk factors commonly associated with the recurrence of CIN following an excisional procedure. Materials and methods: This was a retrospective study conducted between 2010 and 2019. Patients who underwent excisional procedures for CIN2/3 were included. The information was collected from the hospital database. Clinical and sociodemographic data, recurrence characteristics, and follow-up data were analyzed. Results: Recurrent lesions were noted in 26 (15.4%) patients. The pattern of recurrence was CIN in 13 patients (50%), vaginal intraepithelial neoplasia (VAIN) in 11 (42.3%), and cervical cancer in 2 (7.7%) patients. The median follow-up time was 8 (1–117 months). Univariate analysis showed HIV-positive women were at greater risk of recurrence (HR = 2.8, 95% CI = 0.93–8.5; p = 0.009) but advanced age, presence of involved margins, endocervical gland or crypt involvement, and high-risk HPV status post-procedure were not (p > 0.1) associated with recurrence in our study. Conclusion: Excisional procedures are successful and patients with risk factors like HIV seropositivity and positive margins should be targeted for close surveillance or offered a hysterectomy. Clinical significance: Following excisional procedures, patients with risk factors for recurrence should be advised of close surveillance or offered a hysterectomy.

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