Surgical, oncological and obstetric outcomes of Shimodaira-Taniguchi conization method

Abstract

Abstract Background: The objective of the study was to investigate surgical, oncological and obstetric outcomes of Shimodaira-Taniguchi (S-T) conization method. Methods: 858 cases involving high-grade intraepithelial lesions treated by S-T conization were retrospectively reviewed, and the surgical, oncological and obstetric outcomes were analyzed. The χ2 test was used to compare the clinical characteristics between the patients with and without cervical stenosis. Factors associated with recurrent/persistent disease were analyzed by univariate and multivariate analyses using a Cox hazards regression model. The obstetric outcomes after conization were also evaluated. Results: Cervical stenosis and recurrent/persistent disease occurred in 2.2% and 4.9% of the patients, respectively. Older age (age ≥ 45) (Hazard ratio [HR] 3.22, 95% confidence interval [CI] 1.73–6.02) and surgical margin involvement (HR 6.39, 95% CI 3.44–11.8) were independently associated with recurrent/persistent disease. Especially, older patients with endocervical margin involvement showed a higher rate of recurrence (3-year recurrence rate: 28.1%). The proportion of patients who experienced cervical stenosis was significantly higher in older patients (0.95% vs. 5.7%, P < 0.001). Among 66 deliveries after conization, term delivery was observed in 62 cases (93.9%). The proportion of patients who experienced preterm delivery after conization was significantly higher in patients with a short interval from conization to conception (P = 0.045). Conclusions: S-T conization method is effective in terms of surgical, oncological and obstetric outcomes. Careful follow-up is required for older patients with positive surgical margins, especially those with positive endocervical margins. A short interval of ≤ 3 months from conization to conception should be avoided to expect term pregnancy.