5th International Conference on Gynecology and Obstetrics

Will be updated soon

Objective: To identify clinicopathological predictors of recurrence in patients with high-grade squamous intraepithelial lesions (HSIL) treated with loop electrosurgical excision procedure (LEEP).

Materials and Methods: This retrospective study included 337 women with histopathologically confirmed HSIL who underwent LEEP at XXX between 2011 and 2022. Demographic and clinicopathological variables, including age, parity, menopausal status, smoking status, comorbidities, HPV genotype, lesion size, endocervical gland involvement were evaluated. Recurrence was defined as histologically confirmed HSIL during follow-up. Post-treatment cytology was assessed at 4–6 months, and recurrence was monitored during follow-up. Univariate analyses were performed using Chi-square testing and multivariable time to event analysis was performed using Cox regression.

Results: The median age was 37 years (range, 20–67 years) and median follow-up duration was 41 months. Most patients were premenopausal (92.3%) and multiparous (61.6%). Preoperative HPV testing was available in 180 patients, and HPV 16/18 was identified in 100 patients. Recurrence occurred in 12 patients (3.6%). In multivariable analysis, age ≥50 years (HR: 13.4, 95% CI: 3.4–52.2, p < 0.001) and immunological disease (HR: 6.6, 95% CI: 1.4–30.2, p = 0.016) were associated with a higher risk of recurrence, whereas smoking, parity, HPV genotype and endocervical glandular involvement were not significantly associated with recurrence.

Conclusions: Recurrence was uncommon among patients with HSIL treated by LEEP with negative surgical margins. However, older age and immunological disease were associated with an increased risk of recurrence, suggesting the need for individualized follow-up in higher-risk patients.