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Treatment failure following excision therapy of CIN: the impact of direct colposcopic vision during procedure

  • General Gynecology
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Purpose

To assess whether the use of direct colposcopic vision during excision therapy of cervical intraepithelial neoplasia (CIN) has an impact on the risk of treatment failure.

Methods

Data from 285 patients who had had excision therapy with proven CIN at specimen histological analysis were reviewed. Primary endpoint was the occurrence of post-treatment failure defined by the histological diagnosis of CIN 2–3 during follow-up. Data were analysed according to the use of colposcopy at the time of initial therapy of CIN.

Results

The use of direct colposcopic vision (DCV) resulted in a significant reduction in the mean height (p = 0.008) and diameter (p < 0.001) of the excised specimen. Patients’ median follow-up was 28.4 (±1.3) months. A total of 43 (15.2 %) patients were diagnosed with treatment failure. Compared to excisions performed without any use of colposcopy, DCV was not found to have any significant impact on the risk of treatment failure (HR: 0.58; 95 % CI 0.16–2.13, p = 0.412), neither when compared to excisions performed immediately after colposcopy (HR: 0.91; 95 % CI 0.47–1.79; p = 0.794). The only factors found to have a significant impact on the risk of treatment failure was the identification of clear margins (HR: 0.36; 95 %CI 0.19–0.69; p = 0.002) and the diameter of the surgical specimen (HR: 0.94; 95 %CI 0.89–0.99; p = 0.040).

Conclusions

Although the use of DCV during excision therapy of CIN was associated with a significant reduction in the dimensions of the excised cervical specimen, it did not result in a significant change in the risk of treatment failure.

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Authors and Affiliations

  1. Department of Obstetrics and Gynaecology, Hôpital Nord, Assistance Publique des Hôpitaux de Marseille (APHM), Aix-Marseille Université (AMU), Chemin des Bourrely, 13015, Marseille, France

    Mellie Heineman, Léon Boubli & Xavier Carcopino

  2. Aix-Marseille Université, Inserm, IRD, UMR S912, SESSTIM, 13385, Marseille, France

    Julien Mancini, Aubert Agostini, Gilles Houvenaeghel, Léon Boubli & Xavier Carcopino

  3. Public Health Department, APHM, Hôpital de la Timone, BioSTIC, 13385, Marseille, France

    Julien Mancini

  4. Department of Pathology, Assistance Publique des Hôpitaux de Marseille (APHM), Hôpital Nord, Marseille, France

    Julia Villeret

  5. Department of Obstetrics and Gynaecology, Hôpital La Conception, Assistance Publique des Hôpitaux de Marseille, Aix-Marseille Université (AMU), Marseille, France

    Aubert Agostini

  6. Department of Gynecologic Oncology Surgery, Institut Paoli Calmettes (IPC), Aix-Marseille Université (AMU), Marseille, France

    Gilles Houvenaeghel

  7. Laboratory of Biogenotoxicology, IMBE, CNRS, IRD, Université Avignon, Avignon, France

    Xavier Carcopino

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  1. Mellie Heineman
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  2. Julien Mancini
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  3. Julia Villeret
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  4. Aubert Agostini
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  5. Gilles Houvenaeghel
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  7. Xavier Carcopino
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Correspondence to Xavier Carcopino.

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Heineman, M., Mancini, J., Villeret, J. et al. Treatment failure following excision therapy of CIN: the impact of direct colposcopic vision during procedure. Arch Gynecol Obstet 293, 825–831 (2016). https://doi.org/10.1007/s00404-015-3887-7

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  • DOI: https://doi.org/10.1007/s00404-015-3887-7

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