Clinical and pathological predictors of persistence after conization for high-grade squamous intraepithelial lesions: a single-center study

Görkem Aktaş; Belma Gözde Özdemir; Mete Bertizlioğlu; Mercan Aslan; Ahmet Bilgi; Çetin Çelik

Clinical and pathological predictors of persistence after conization for high-grade squamous intraepithelial lesions: a single-center study

Abstract

Aims: High-grade squamous intraepithelial lesion (HSIL) is among the important precursor lesions of cervical cancer, and progression to invasive cancer can be largely prevented with early diagnosis and appropriate treatment. Excisional procedures, especially loop electrosurgical excision procedure (LEEP), are commonly used to treat HSIL. However, the persistence or recurrence of the lesion after excisional treatment in some patients remains a clinically significant problem. Surgical margin status, human papillomavirus (HPV) infection, and various clinical factors are thought to play a role in the development of persistence. Therefore, identifying the factors that affect persistence after excisional treatment is important for optimizing follow-up and management strategies for patients. The aim of this study is to evaluate demographic, clinical, and pathological factors associated with post-treatment persistence in patients diagnosed with HSIL and treated with conization. Methods: This retrospective study was conducted at a tertiary referral center and included patients diagnosed with HSIL and treated with conization between 2024 and 2025. A total of 69 patients with histopathologically confirmed HSIL were included in the study. Persistence was observed in 46 patients (66.7%), while no persistence was observed in 23 patients (33.3%). Demographic characteristics, clinical findings, and pathological data of the patients were retrospectively reviewed from their patient files. Data collected included age, surgical margin status, length of the removed specimen, and HPV status during follow-up. Patients were divided into two groups based on whether persistence developed during follow-up. Correlation analyses and logistic regression models were used to evaluate factors associated with persistence. Results: No significant differences were found between patients with and without persistence in terms of age, menopausal status, marital status, and smoking (p>0.05). However, positive surgical margins were significantly associated with persistence (p=0.003). In the evaluation of clinicopathological factors, the persistence rate was significantly higher in patients with positive high-risk HPV types (e.g., HPV 16, HPV 31) during follow-up (p=0.002). In logistic regression analysis, positive surgical margins and positive HPV status at follow-up were significant predictors of persistence. Conclusion: Positive surgical margins and HPV positivity during follow-up are significantly associated with persistence after excisional HSIL treatment.

Keywords

Supporting Institution

No funding.

Ethical Statement

The study was approved by the Ethics Committee of Selcuk University Faculty of Medicine (Approval No 2026/163) and was conducted in accordance with the Declaration of Helsinki. Written informed consent was obtained from all participants prior to enrollment.

Thanks

none

References

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Details

Primary Language

English

Subjects

Gynecologic Oncology Surgery

Journal Section

Research Article

Authors

Görkem Aktaş ^*
0000-0001-8402-5536
Türkiye

Belma Gözde Özdemir
0000-0002-7025-4087
Türkiye

Mete Bertizlioğlu
0000-0003-1557-5774
Türkiye

Mercan Aslan
0009-0003-6409-152X
Türkiye

Ahmet Bilgi
0000-0001-8682-1739
Türkiye

Çetin Çelik
0000-0001-6165-5092
Türkiye

Publication Date

June 25, 2026

Submission Date

March 16, 2026

Acceptance Date

April 18, 2026

Published in Issue

Year 2026 Volume: 7 Number: 3

IZ

https://izlik.org/JA49SK93SW

Cite

RIS / Bibtex

APA

Aktaş, G., Özdemir, B. G., Bertizlioğlu, M., Aslan, M., Bilgi, A., & Çelik, Ç. (2026). Clinical and pathological predictors of persistence after conization for high-grade squamous intraepithelial lesions: a single-center study. Journal of Medicine and Palliative Care, 7(3), 457-461. https://izlik.org/JA49SK93SW

AMA

1.Aktaş G, Özdemir BG, Bertizlioğlu M, Aslan M, Bilgi A, Çelik Ç. Clinical and pathological predictors of persistence after conization for high-grade squamous intraepithelial lesions: a single-center study. J Med Palliat Care / JOMPAC / jompac. 2026;7(3):457-461. https://izlik.org/JA49SK93SW

Chicago

Aktaş, Görkem, Belma Gözde Özdemir, Mete Bertizlioğlu, Mercan Aslan, Ahmet Bilgi, and Çetin Çelik. 2026. “Clinical and Pathological Predictors of Persistence After Conization for High-Grade Squamous Intraepithelial Lesions: A Single-Center Study”. Journal of Medicine and Palliative Care 7 (3): 457-61. https://izlik.org/JA49SK93SW.

EndNote

Aktaş G, Özdemir BG, Bertizlioğlu M, Aslan M, Bilgi A, Çelik Ç (June 1, 2026) Clinical and pathological predictors of persistence after conization for high-grade squamous intraepithelial lesions: a single-center study. Journal of Medicine and Palliative Care 7 3 457–461.

IEEE

[1]G. Aktaş, B. G. Özdemir, M. Bertizlioğlu, M. Aslan, A. Bilgi, and Ç. Çelik, “Clinical and pathological predictors of persistence after conization for high-grade squamous intraepithelial lesions: a single-center study”, J Med Palliat Care / JOMPAC / jompac, vol. 7, no. 3, pp. 457–461, June 2026, [Online]. Available: https://izlik.org/JA49SK93SW

ISNAD

Aktaş, Görkem - Özdemir, Belma Gözde - Bertizlioğlu, Mete - Aslan, Mercan - Bilgi, Ahmet - Çelik, Çetin. “Clinical and Pathological Predictors of Persistence After Conization for High-Grade Squamous Intraepithelial Lesions: A Single-Center Study”. Journal of Medicine and Palliative Care 7/3 (June 1, 2026): 457-461. https://izlik.org/JA49SK93SW.

JAMA

1.Aktaş G, Özdemir BG, Bertizlioğlu M, Aslan M, Bilgi A, Çelik Ç. Clinical and pathological predictors of persistence after conization for high-grade squamous intraepithelial lesions: a single-center study. J Med Palliat Care / JOMPAC / jompac. 2026;7:457–461.

MLA

Aktaş, Görkem, et al. “Clinical and Pathological Predictors of Persistence After Conization for High-Grade Squamous Intraepithelial Lesions: A Single-Center Study”. Journal of Medicine and Palliative Care, vol. 7, no. 3, June 2026, pp. 457-61, https://izlik.org/JA49SK93SW.

Vancouver

1.Görkem Aktaş, Belma Gözde Özdemir, Mete Bertizlioğlu, Mercan Aslan, Ahmet Bilgi, Çetin Çelik. Clinical and pathological predictors of persistence after conization for high-grade squamous intraepithelial lesions: a single-center study. J Med Palliat Care / JOMPAC / jompac [Internet]. 2026 Jun. 1;7(3):457-61. Available from: https://izlik.org/JA49SK93SW