Predictive Value of 6-Month Cotest Results for Recurrence After Cervical Excision in Cervical Intraepithelial Neoplasia: A Single-Center Experience
Eastern Journal of Medicine, vol.31, no.3, pp.457-463, 2026 (Scopus, TRDizin)
- Publication Type: Article / Article
- Volume: 31 Issue: 3
- Publication Date: 2026
- Doi Number: 10.5505/ejm.2026.74875
- Journal Name: Eastern Journal of Medicine
- Journal Indexes: Scopus, EMBASE, TR DİZİN (ULAKBİM), Academic Search Ultimate (EBSCO), Biomedical Reference Collection: Corporate Edition (EBSCO), Health Research Premium Collection (ProQuest), Pharma Collection (ProQuest)
- Page Numbers: pp.457-463
- Keywords: Cervical excision, Cervical intraepithelial neoplasia, Cotesting, Cytology, Human papillomavirus, Recurrence
- Istanbul University-Cerrahpasa Affiliated: Yes
Abstract
To evaluate the predictive value of 6-month postoperative cotest results for recurrence in patients who underwent cervical excisional treatment for cervical intraepithelial neoplasia (CIN) 2–3. This retrospective cohort study included patients who underwent cervical excisional procedures for CIN 2 –3 between January 2016 and May 2025 at a tertiary gynecologic oncology center. Patients with prior cervical excision or hysterectomy for dysplasia were excluded. Demographic, clinical, and pathological data were collected from medical records. Cytology and human papillomavirus (HPV) test results obtained at the 6-month postoperative follow-up were analyzed. Cytology results were classified as normal or abnormal (ASC-US or higher), and HPV results as positive or negative. Recurrence was defined as histopathologically confirmed CIN 2 or higher detected after the 6-month follow-up period. A total of 789 patients were included. Baseline demographic and pathological characteristics were similar between recurrence and non-recurrence groups. A total of 789 patients were included, of whom 49 (6.2%) developed recurrence. At the 6-month follow-up, abnormal cytology was significantly more frequent among patients who d eveloped recurrence (p<0.05). All patients with recurrence were HPV positive at 6 months, while no recurrence was observed among HPV-negative patients (p<0.05) during the available follow-up period. Correlation analysis demonstrated a moderate positive association between 6-month HPV positivity and recurrence (r=0.571; p<0.01), and a lower but significant correlation for cytology results (r=0.320; p<0.01). Six-month postoperative cotest results are strongly associated with recurrence after cervical excisi on for CIN 2–3. Persistent HPV positivity emerged as the most important predictor of recurrence, while the addition of cytology improved risk stratification. These findings support the clinical value of HPV-based follow-up strategies and the use of 6-month cotest results to individualize postoperative surveillance.