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814 Impact of the type of conization, the volume and dimensions of the cone with the persistence/recurrence of cervical intraepithelial neoplasia 2–3
  1. Gonzalo Arturo Medina Bueno1,
  2. Maria Eulalia Fernández-Montoli1,
  3. Jordi Ponce1,
  4. Sara Tous2 and
  5. Judith Peñafiel-Muñoz2
  1. 1Gyneacologic Department, University Hospital of Bellvitge (IDIBELL), University of Barcelona, Barcelona, Spain
  2. 2Bellvitge University Hospital (IDIBELL), Barcelona, Spain


Introduction/Background High-grade cervical intraepithelial neoplasia (CIN2–3) is a premalignant condition that requires intervention. The objectives of this study were to evaluate the relationship between conization type and the volume and dimensions of the cone, in addition to the persistence/recurrence of CIN2–3, the presence of affected margins, and post-cone HR-HPV positivity.

Methodology A total of 227 women with histologically confirmed CIN2–3 who were treated with LLETZ were evaluated between 1996 and 2006 and followed up until June 2016. Age, type of resection according to IFCPC 2011, volume, cone dimensions, margins of resection, post-cone high-risk human papillomavirus (HR-HPV) status, and viral load were studied. Determinants of HR-HPV posi-tivity were estimated using unconditional logistic regression and times to recurrence were as-sessed using Kaplan-Meier curves.

Results Persistent/recurrent CIN2–3 was found in 12 cases (5.2%). Type 1 conization was performed in 81 patients, with 5 recurrences (6.1%); type 2 in 101 patients, with 6 recurrences (5.9%); and type 3 resection in 45 patients, with 1 recurrence (2.2%). The volume and dimensions of the cone were not associated with recurrence. The log-rank test did not show a significant difference between the three treatments (p = 0.18). The free margins in type 1 resection were 37%, those in type 2 resection were 61%, and those in type 3 resection were 71% (p = 0.001). Type 1 resection was associated with 15% post-cone HR-HPV positivity, type 2 reached 16%, and type 3 had 9%; this difference was non-significant (p = 0.58). The incidence of recurrence at 36 months in the type 1 resection group was 0.08%; in the type 2 treatment it was 0.04%; and in the type 3 resection group, it was 0.0%

Conclusion Type 3 resection was associated with a higher proportion of free margins and lower post-cone HR-HPV positivity, with a lower incidence of persistence/recurrence

Disclosures The authors have nothing to disclose.

Abstract 814 Table 1

Characteristics of the surgical specimen according to type of treatment

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