J Gynecol Oncol | Volume 3, Issue 2 | Research Article | Open Access

A Review of Cervical Cancer Precursor Lesions and Recurrence after Treatment: What are the Real Risk Factors?

Newton SDC¹, Andresa IF¹, Fernanda VF^2*, Natasha SCA¹ and Carlos AM²

¹Department of Gynecology and Obstetrics, UFPR University, Brazil
²Department of Gynecology and Obstetrics, Positivo University, Brazil

^*Correspondance to: Fernanda Villar Fonseca 

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Abstract

Objective: To evaluate the predictive factors that can influence recurrence of HSIL after treatment with LEEP or with cervical conization and show review from the literature the level of influence of each factor. Methodology: We reviewed scientific publications after 2000 in PubMed, Web of Science, Scopus, LILACS databases to demonstrate factors that are related to the recurrence of HSIL after surgical treatment. To show the level of influence, the conditions were divided according to arbitrate convention: Indicative of evidence, lack of evidence and debatable. Results: Factors that indicate increased risk of recurrence independent of importance scale were: Older age, HIV positive, HPV 16 presence, HPV viral load, glandular extension of the lesion, p16 and Ki-67 presence, depth of resection in conization, positivity of margins, number of quadrants involved by lesion, and non-HPV vaccination. Age at first sexual intercourse, use of oral contraceptives, parity, smoking, previous pregnancy, grade of intraepithelial neoplasia before conization and colposcopy gradation of the lesion did not show evidence of recurrence of the disease. The volume of the excised piece ant the presence of other HPV oncogenic types no 16 or 18 had debatable evidence. Conclusion: Factors that are indicative of recurrence of HSIL were: older age, HIV positive, HPV 16 presence, HPV viral load, glandular extension, conization depth, positivity of that markers p16 and Ki-67, positivity of margins, lesion included in multiple quadrants and not vaccinating against HPV. Patients who present some of these isolated factors or in association should be alert for a greater recurrence possibility.

Keywords:

HSIL; Conization; LEEP; Recurrence; Cervical intraepithelial neoplasia

Citation:

Newton SDC, Andresa IF, Fernanda VF, Natasha SCA, Carlos AM. A Review of Cervical Cancer Precursor Lesions and Recurrence after Treatment: What are the Real Risk Factors?. J Gynecol Oncol. 2020; 3(2): 1029.