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Risk factors for treatment failure following cold coagulation cervical treatment for CIN pathology: a cohort-based study

Papoutsis, D.; Underwood, M.; Parry-Smith, W.; Panikkar, J.

Authors

D. Papoutsis

M. Underwood

J. Panikkar



Abstract

Purpose
To determine any risk factors for cytology recurrence in women after cold coagulation ablative treatment for cervical intraepithelial neoplasia (CIN).

Methods
This was a retrospective observational study of a cohort of women having had cold coagulation between 2001 and 2011 in the colposcopy unit of an NHS hospital. We retrospectively collected data from our colposcopy unit database. Women with previous cervical treatment were excluded.

Results
559 eligible women were identified with a mean age of 28.7 ± 6.2 years. Nulliparous women were 66.3 % with smokers involving 35.3 %. Referral cytology, pretreatment cervical punch biopsies and colposcopy were high grade in 51.9, 71.9 and 45.8 % of women. Endocervical crypt involvement (ECI) on pretreatment cervical punch biopsy involved 9.7 % of women. Mean follow-up was 3.1 ± 2.4 years. Overall cytology recurrence (mild/moderate/severe dyskaryosis) at 6 and 12 months follow-up was 7.4 and 5 %. High-grade cytology recurrence (moderate/severe dyskaryosis) involved 2.7 % of women over the entire follow-up period. Multiple regression analysis showed that ECI on pretreatment cervical punch biopsy was a risk factor for high-grade cytology recurrence (HR 3.72; 95 %CI 1.18–11.71; p = 0.024). There were no risk factors identified for overall cytology recurrence. However, when cytology tests with borderline nuclear changes at follow-up were pooled with mild/moderate/severe dyskaryosis cytology tests, then parity ≥2 was a risk factor for abnormal cytology (HR 1.71; 95 %CI 1.08–2.69; p = 0.022).

Conclusions
Endocervical crypt involvement on pretreatment cervical punch biopsy and multiparity ≥2 are risk factors that increase the likelihood of abnormal cytology following cold coagulation. These two risk factors should be taken in consideration when performing cold coagulation cervical treatment for CIN pathology.

Citation

Papoutsis, D., Underwood, M., Parry-Smith, W., & Panikkar, J. (2015). Risk factors for treatment failure following cold coagulation cervical treatment for CIN pathology: a cohort-based study. Archives of Gynecology and Obstetrics, 292, 1329-1337. https://doi.org/10.1007/s00404-015-3761-7

Journal Article Type Article
Acceptance Date May 13, 2015
Online Publication Date May 26, 2015
Publication Date 2015
Deposit Date Jun 14, 2024
Journal Archives of Gynecology and Obstetrics
Print ISSN 0932-0067
Publisher Springer Verlag
Peer Reviewed Peer Reviewed
Volume 292
Pages 1329-1337
DOI https://doi.org/10.1007/s00404-015-3761-7
Public URL https://keele-repository.worktribe.com/output/773653
Publisher URL https://link.springer.com/article/10.1007/s00404-015-3761-7
Related Public URLs https://pubmed.ncbi.nlm.nih.gov/26006259/