{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,20]],"date-time":"2025-11-20T12:50:33Z","timestamp":1763643033528},"reference-count":19,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2020,11,20]],"date-time":"2020-11-20T00:00:00Z","timestamp":1605830400000},"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":["J of Obstet and Gynaecol"],"published-print":{"date-parts":[[2021,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>The value of top\u2010hat procedure during loop electrosurgical excision procedure (LEEP) for squamous intraepithelial lesions had remained controversial. This study aimed to evaluate whether top\u2010hat specimens positive for cervical intraepithelial neoplasia (CIN) on histopathology can serve as an independent risk factor to predict treatment failure.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We reviewed the medical records of patients who underwent LEEP and top\u2010hat procedures in Peking University First Hospital between 2011 and 2016 and collected their follow\u2010up data until January 2019. We compared the pathological risk factor of treatment failure. Multivariate analysis was carried out to clarify the independent determinant of treatment failure. A Cox model was used to assess the influence of different variables on cumulative treatment failure rates.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>This study included 295 cases for short\u2010term treatment failure, and among them, 178 cases were used to study the long\u2010term. The presence of CIN in top\u2010hat was relevant to short\u2010term treatment failure (OR = 9.64, 95% CI 2.55\u201336.4) despite a clear margin. On multivariate analysis, top\u2010hat result (OR = 3.58, 95% CI 1.30\u20139.89), age\u2009\u2265\u200950 (OR = 10.2, 95%CI 3.64\u201328.3) and post\u2010treatment HPV 16\/18 infection (OR = 2.35, 95%CI 1.19\u20134.63) were independent risk factors in predicting short\u2010term failure. In the Cox model, these factors were also associated with higher cumulative failure rates.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The current study supported the predictive value of top\u2010hat procedure in short\u2010term failure after LEEP. Typically, women with positive top\u2010hat need closer follow\u2010up despite their negative margin status. Older women with positive top\u2010hat findings and HPV 16\/18 infections after the treatment suffer a higher risk of short\u2010term failure.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jog.14578","type":"journal-article","created":{"date-parts":[[2020,11,21]],"date-time":"2020-11-21T01:46:50Z","timestamp":1605923210000},"page":"661-668","update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Predictors of treatment failure after top\u2010hat procedure in squamous intraepithelial lesion"],"prefix":"10.1111","volume":"47","author":[{"given":"Xuhao","family":"Chen","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology Peking University First Hospital  Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Birao","family":"Fan","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Peking University First Hospital  Beijing 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