Triage for management of cervical high-grade squamous intraepithelial lesion patients with positive margin by conization:a retrospective analysis
10.1007/s11684-017-0517-8
- Author:
Dou YUYA
1
;
Zhang XIAODAN
;
Li YANG
;
Wang FENFEN
;
Xie XING
;
Wang XINYU
Author Information
1. Women's Hospital Zhejiang University School of Medicine
- Keywords:
cervical high-grade squamous intraepithelial lesion;
conization;
positive surgical margin;
hysterectomy
- From:
Frontiers of Medicine
2017;11(2):223-228
- CountryChina
- Language:Chinese
-
Abstract:
The objective of this study is to guide a triage for the management of cervical high-grade squamous intraepithelial lesion (HSIL) patients with positive margin by conization.Clinico-pathological data of HSIL patients with positive margin by conization were retrospectively collected from January 2009 to December 2014.All patients underwent secondary conization or hysterectomy within 6 months.The rate of residual lesion was calculated,and the factors associated with residual lesion were analyzed by univariate and multivariate analyses.Among a total of 119 patients,56 (47.06％) patients presented residual HSIL in their subsequent surgical specimens,including 4 cases of invasive cervical carcinoma (3 stage IA1 and 1 stage IA2 patients).Univariate analysis showed that patient age ＞ 35 years (P =0.005),menopausal period ＞ 5 years (P =0.0035),and multiplequadrant involvement (P=0.001) were significantly correlated with residual disease;however,multivariate analysis revealed that multiple-quadrant involvement (P=0.001;OR,3.701;95％CI,1.496-9.154) was an independent risk factor for residual disease.Nearly half of HSIL patients with positive margin by conization were disease-free in subsequent surgical specimens,and those with multiple positive margins may consider reconization or re-assessment.
