{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T13:32:22Z","timestamp":1791379942180,"version":"4.3.3"},"reference-count":24,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2019,12,14]],"date-time":"2019-12-14T00:00:00Z","timestamp":1576281600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2020,2]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To assess the long\u2010term risk factors predicting residual\/recurrent cervical intraepithelial neoplasia (CIN 2\u20133) and time to recurrence after large loop excision of the transformation zone (LLETZ).<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Retrospective study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Colposcopy clinic.<\/jats:p><\/jats:sec><jats:sec><jats:title>Population<\/jats:title><jats:p>242 women with CIN 2\u20133 treated between 1996 and 2006 and followed up until June 2016.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Age, margins, and high\u2010risk human papillomavirus (HR\u2010HPV) were estimated using Cox proportional hazard and unconditional logistic regression models. The cumulative probability of treatment failure was estimated by Kaplan\u2013Meier analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcome measure<\/jats:title><jats:p>Histologically confirmed CIN 2\u20133, HR\u2010HPV, margins, age.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>CIN 2\u20133 was associated with HR\u2010HPV (HR\u00a0=\u00a030.5, 95% confidence interval [CI]\u00a0=\u00a03.80\u2013246.20), age &gt;35\u00a0years (HR\u00a0=\u00a05.53, 95% CI\u00a0=\u00a01.22\u201325.13), and margins (HR\u00a0=\u00a07.31, 95% CI\u00a0=\u00a01.60\u201333.44). HR\u2010HPV showed a sensitivity of 88.8% and a specificity of 80%. Ecto<jats:sup>+<\/jats:sup>\/endocervical<jats:sup>+<\/jats:sup> (16.7%), uncertain (19.4%) and ecto<jats:sup>\u2212<\/jats:sup>\/endocervical<jats:sup>+<\/jats:sup> margins (9.1%) showed a higher risk of recurrence (odds ratio [OR]\u00a0=\u00a013.20, 95% CI\u00a0=\u00a01.02\u2013170.96; OR = 15.84, 95% CI\u00a0=\u00a03.02\u201383.01; and OR = 6.60, 95% CI\u00a0=\u00a00.88\u201349.53, respectively). Women with involved margins and\/or who were HR\u2010HPV positive had more treatment failure than those who were HR\u2010HPV negative or had clear margins (<jats:italic>P<\/jats:italic>\u2010log\u2010rank\u00a0&lt;0.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>HR\u2010HPV and margins seem essential for stratifying post\u2010LLETZ risk, and enable personalised management. Given that clear margins present a lower risk, a large excision may be indicated in older women to reduce the risk.<\/jats:p><\/jats:sec><jats:sec><jats:title>Tweetable abstract<\/jats:title><jats:p>After LLETZ for CIN 2\u20133, recurrences appear more often in women with positive HR\u2010HPV and involved margins and aged over 35.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1471-0528.15996","type":"journal-article","created":{"date-parts":[[2019,10,21]],"date-time":"2019-10-21T05:44:20Z","timestamp":1571636660000},"page":"377-387","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":56,"title":["Long\u2010term predictors of residual or recurrent cervical intraepithelial neoplasia 2\u20133 after treatment with a large loop excision of the transformation zone: a retrospective 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