Risk factors for cervical intraepithelial neoplasia recurrence after conization: A 10-year study

Maurizio Serati, Gabriele Siesto, Simona Carollo, Giorgio Formenti, Cristina Riva, Antonella Cromi, Fabio Ghezzi

Research output: Contribution to journalArticlepeer-review


Objective: To evaluate the risk factors potentially involved in the development of cervical intraepithelial neoplasia (CIN) recurrence after cervical conization in a long-term follow-up period. Study design: Consecutive patients with histologically proven CIN who had undergone either cold knife conization or a loop electrosurgical excision procedure were enrolled and scheduled for serial follow-up examinations over a 10-year period. Data were stored in a digital database. Multivariate analysis was performed to identify factors for recurrence. Results: Between January 1999 and December 2009, 282 patients fulfilled the inclusion criteria and were included in the final statistical analysis. After a median follow-up of 26.7 months (range 6-100), 64 (22.7%) women developed histologically confirmed recurrence. The 2-year recurrence-free survival was 83.7% and 66.7% for women with negative and positive margins, respectively (p = 0.008). The 5-year recurrence-free survival was 75.4% and 50.3% for patients with negative and positive margins, respectively (p = 0.0004). Positive surgical margin was the most important independent predictor of recurrence [HR 2.5 (95%CI 1.5-4.5), p = 0.0007; Wald 11.338]. After multinomial logistic regression the indication for conization based on persistent CIN1 was the only independent predictor for negative margin [OR 0.3 (95%CI 0.1-0.7), p = 0.008]. Conclusions: Our study demonstrated that the surgical margin status represents the most important predictor for CIN recurrence after conization. After excisional therapy, close follow-up is mandatory for the early detection of recurrent disease. The identification of risk factors for recurrence may guide clinical decision-making on expectant management versus re-intervention.

Original languageEnglish
Pages (from-to)86-90
Number of pages5
JournalEuropean Journal of Obstetrics and Gynecology and Reproductive Biology
Issue number1
Publication statusPublished - Nov 2012


  • CIN
  • Cold knife conization
  • HPV
  • LEEP
  • SIL
  • Surgical margins

ASJC Scopus subject areas

  • Obstetrics and Gynaecology
  • Reproductive Medicine


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