Julio C. González-Rodríguez, Departamento de Oncología Ginecológica, Instituto Nacional de Cancerología, Ciudad de México, México
Salim A. Barquet-Muñoz, Departamento de Oncología Ginecológica, Instituto Nacional de Cancerología, Ciudad de México, México
Emmanuel Mejorada-Pulido, Departamento de Oncología Ginecológica, Instituto Nacional de Cancerología, Ciudad de México, México
Luz A. Ugarte-Julio, Hospital Universitario San Jorge de Pereira, Colombia
Mariel Zepeda-Fong, Clínica de Displasias, Departamento de Ginecología, Hospital de Gineco-Obstetricia, Instituto Mexicano del Seguro Social, Torreón, Coahuila, México
Anahí Sánchez-Rodríguez, Centro Médico Nacional La Raza, Instituto Mexicano del Seguro Social, Ciudad de México, México
Background: Cervical cancer is one of the leading causes of death among women in countries with middle to high income levels. Objective: Stratifying the predictors of recurrence/persistence of grade 2 or 3 CIN after primary conization in different age groups, is the object of analysis of our study. Material and methods: A total of 432 women with cervical intraepithelial neoplasia (CIN) attended from January 2017 to May 2020 were included. Information regarding age at diagnosis, immunosuppression and cytologic, colposcopy, LEEP or cervical cone biopsy and histopathological results were acquired. Recurrence incidence was calculated over follow-up time in months. To evaluate the association between patient’s characteristics and recurrence, we calculated hazard ratio (HR) with 95% CI. Results: We observed 25 recurrences from 432 women and 4,869 months of follow-up (5.13 incidence per 1,000 months). Median age was 38 years old. Median follow-up was 6.8 months. The recurrence-free period at 1, 2 and 3 years was 95.47%, 82.18% and 44.09% respectively. In the bivariate analysis, factors associated with the risk of recurrence were the following: high grade cytological diagnosis (HR = 3.04, IC 95% = 1.18-7.31), colposcopy grade 2 or cancer suspected (HR = 3.04, IC 95% = 1.25-7.22), high grade biopsy diagnosis (HR = 3.07, IC95 % = 1.28-7.30), LEEP or hysterectomy (HR = 2.85, IC95 % = 1.19-6.78). Conclusions: High-grade lesions, colposcopy findings and pathological diagnosis were also associated with disease recurrence.
Keywords: Papillomavirus infections. Squamous intraepithelial lesions of the cervix. Persistence. Recurrence. Human papillomavirus.