Clinical Outcomes of Cases with Cervical Dysplasia Absent in Cold Knife Conization Specimens


Background: Cold knife conization is a surgical procedure that allows both diagnosis and treatment of cervicallesions at the same time. It is mainly performed for indications of high-grade cervical intraepithelial neoplasia(CIN). In this study, we aimed to investigate the clinical outcome of cases without CIN in cold knife conizationspecimen, following a high-grade lesion (CIN2/3) in cervical biopsy. Materials and
Methods: We performed aretrospective cohort study at a tertiary referral hospital between January 1st 2008 and August 1st 2012. Cases thatunderwent cold knife conization for CIN2/3 within the study period were included. Cone-negative (Group 1) andcone-positive (Group 2) cases were analyzed for various clinical parameters, and were compared in the 1-yearpost-conization period for histological recurrence and human papillomavirus (HPV) DNA status.
Results: A totalof 173 women underwent cold knife conization for CIN2/3 within the study period. Twenty-two cases (12.7%)were included in Group 1 and 151 cases (87.3%) in Group 2. There were no significant differences between thetwo groups in terms of age, gravidity, parity, menopausal status and HPV-DNA status (pre-conization and 1year post-conization) (p>0.05). Recurrence rates were also similar between the groups (9.1% vs 9.9%, p>0.05).
Conclusions: Clinical outcomes were similar in terms of histological recurrence and HPV persistence after 1year of follow-up between cone-negative and cone-positive cases. Clinical follow-up of cone-negative cases shouldtherefore be performed similar to cone-positive cases.