Year: 2024
Type: article
Study design: Observational Study
Abstract: The present study aimed to investigate the surgical, oncological and obstetric outcomes of the Shimodaira-Taniguchi (S-T) conization method.A total of 858 cases of high-grade intraepithelial lesions treated with S-T conization were retrospectively reviewed, and the surgical, oncological and obstetric outcomes were analyzed.The χ 2 test was used to compare the clinical characteristics between patients with and without cervical stenosis.The factors associated with recurrent/persistent disease were analyzed using univariate and multivariate analyses with a Cox hazards regression model.The obstetric outcomes after conization were also evaluated.Cervical stenosis and recurrent/persistent disease occurred in 2.2 and 4.9% of the patients, respectively.Older age [≥45 years; hazard ratio (HR), 3.22; 95% CI, 1.73-6.02]and surgical margin involvement (HR, 6.39; 95% CI, 3.44-11.8)were independently associated with recurrent/persistent disease.In particular, older patients with endocervical margin involvement showed a higher rate of recurrence (3-year recurrence rate, 28.1%).The proportion of patients who experienced cervical stenosis was significantly higher in older patients (0.95 vs. 5.7%; P<0.001).Among the 66 deliveries after conization, term delivery was observed in 62 cases (93.9%).The proportion of patients who experienced preterm delivery after conization was significantly higher in patients with a short interval from conization to conception (P= 0.045).In conclusion, the S-T conization method was effective in terms of surgical, oncological and obstetric outcomes.A careful follow-up is required for older patients with positive surgical margins, particularly those with positive endocervical margins.In addition, a short interval of ≤3 months from conization to conception should be avoided to expect term pregnancy.
Source: Molecular and Clinical Oncology
Institution: Osaka Rosai Hospital
Language: English
Subfield: Epidemiology
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W4402365882