MicroMedicine ISSN 2449-8947 MicroMedicine 2018; 6 (1): 10-15 RESEARCH ARTICLE Predictors of residual disease after loop electrosurgical excision procedure Citation: de Hollanda ACDF, Gonçalves AK, Jatobá CA, Fabricio TND, da Silva AF, Cobucci RN. Predictors of residual disease after loop electrosurgical excision procedure. MicroMed. 2018; 6(1): 10-15. DOI: http://dx.doi.org/10.5281/zenodo.1173700 Received: December 23, 2017 Revised: February 10, 2018 Accepted: February 15, 2018 Copyright: © 2018 de Hollanda ACDF, et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. www.journals.tmkarpinski.com/index.php/mmed Transparency declaration: The authors declare no conflicts of interest. Ethical considerations: Approval was obtained from the institutional review board of Federal University Hospital in Brazil. Ana Carolina Dantas Fabricio de Hollanda 1 , Ana Katherine Gonçalves 2 , Carlos André Jatobá 3 , Teresa Neumann Dantas Fabricio 4 , Adalberto Fabricio da Silva 5 , Ricardo Ney Cobucci 6 * 1 Gynecological Resident, Federal University of Rio Grande do Norte, UFRN, Natal, Brazil 2 Department of Gynecology and Obstetrics, Federal University of Rio Grande do Norte, UFRN, Natal, Brazil 3 Department of Pathology, Federal University of Rio Grande do Norte, UFRN, Natal, Brazil 4 Teaching and Research Management, Federal University of Rio Grande do Norte, UFRN, Natal, Brazil 5 Federal University of Rio Grande do Norte, UFRN, Natal, Brazil 6 Department of Gynecology and Obstetrics, Potiguar University, UnP, Natal, Brazil *Corresponding author: Ricardo Ney Cobucci; Abel Cabral Av. 2035/101, Parnamirim, Postal Code 59151-250, Brazil; Phone: +558420209051; E-mail: rncobucci@hotmail.com ABSTRACT The study aims to evaluate the importance of resection margins in the risk of residual disease (RD) and to investigate other factors that could potentially predict RD before patients engage in follow-up. Eighty-six women with a histologically confirmed diagnosis of cervical intraepithelial neoplasms (CIN) treated by loop electrosurgical excision procedure (LEEP), were included in this retrospective study, between January 2015 and May 2016. Age, smoking habit, menopause status, and LEEP margins were evaluated as possible predictors of RD. The mean age at diagnosis was 35.8 years (range 18-61). The mean follow- up period was 12 months. 11.6% of patients (09/86) were lost in follow-up. 64% of patients (55/86) had clear margins in the specimen and 34.8% of patients had positive surgical margins (30/86). In 1.2% of patients (01/86) the resection margins were uncertain. RD was demonstrated by positive Pap Smear and by colposcopy-guided biopsy in 26.7% of patients (23/86). We found significant differences in the frequency of RD depending on the status of margins: 65.2% of cases with positive margins vs. 24.5% of cases with negative margins (p<0.0001). Multivariate analysis showed that only high-grade squamous intraepithelial lesion (H-SIL) detection in cervical biopsy and status of the LEEP margins were significantly predictive of RD (OR 5.4, 95%CI 1.08- 27.7, p<0.05 and OR 7.05, 95%CI 2.1-23.1, p=0.001; respectively). The combination of histological examination of resection margins plus H-SIL detection in cervical biopsy would help to classify LEEP-treated patients into categories of different risk levels of residual disease. Keywords: Cervical intraepithelial neoplasia; Minimal residual disease; Conization; Papillomavirus infections.