Parous women with precancerous cervical lesion are nearly three times more likely to experience a recurrence of the disease after loop electrosurgical excisional procedure (LEEP), according to a study from South Korea published in the Journal of Obstetrics and Gynaecology Research.¹

A team of researchers from the Dept. of Obstetrics and Gynecology, Gachon University College of Medicine, Incheon in Korea retrospectively reviewed records of 117 patients who underwent LEEP for precancerous lesions of the cervix between 2012 and 2014 and had a positive margin. Their aim was to identify the factors predictive of risk of recurrence of cervical precancerous lesions in these patients.

Out of the 117 patients included in the study, 26 (22.2%) patients had recurrence. After adjusting for multiple variables such as age, parity, menopausal status, smoking, human papillomavirus (HPV) infection, results of cytology/biopsy/LEEP, and specimen size and volume, it was found that the parous women were significantly more likely to experience a recurrence with adjusted hazard ratio (aHR) of 2.92, but a negative correlation was noted for positive margins at the endocervix (aHR 0.39) and volume ≥4000 mm3 (aHR 0.36). The study therefore concluded that a history of previous delivery, positive margin at the endocervix, and specimen volume of LEEP <4000 mm3 are factors that increase the likelihood of recurrence of precancerous lesions of the cervix. “These results could help gynecologists determine optimal treatment options for patients with positive margins,” concluded the authors.

Reference

1. Soo Hyun Oh, et al. Risk factors for recurrence of cervical intraepithelial neoplasia after loop electrosurgical excisional procedure in patients with positive margins. J Obstet Gynaecol Res. 2023 Jun 5. doi: 10.1111/jog.15704.