Abstract
The present study aimed to investigate the surgical, oncological and obstetric outcomes of the Shimodaira-Taniguchi (S-T) conization method. A total of 858 cases of high-grade intraepithelial lesions treated with S-T conization were retrospectively reviewed, and the surgical, oncological and obstetric outcomes were analyzed. The χ(2) test was used to compare the clinical characteristics between patients with and without cervical stenosis. The factors associated with recurrent/persistent disease were analyzed using univariate and multivariate analyses with a Cox hazards regression model. The obstetric outcomes after conization were also evaluated. Cervical stenosis and recurrent/persistent disease occurred in 2.2 and 4.9% of the patients, respectively. Older age [≥45 years; hazard ratio (HR), 3.22; 95% 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. In particular, 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 the 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). In conclusion, the S-T conization method was effective in terms of surgical, oncological and obstetric outcomes. A careful follow-up is required for older patients with positive surgical margins, particularly those with positive endocervical margins. In addition, a short interval of ≤3 months from conization to conception should be avoided to expect term pregnancy.