Human papillomavirus infection and the size and grade of cervical intraepithelial neoplastic lesions associated with failure of therapy.

Objective: This investigation was designed to identify specific risk factors associated with treatment failure for cervical intraepithelial neoplasia.

Method: A cohort of 436 women was assessed for the presence of cofactors associated with therapy failure. The risk factors included the HPV infection status of the patient, a previous history of genital condyloma and the size of cervical lesions.

Result: The treatment outcome was not related to the treatment modality (P = 0.058). Thirteen (8.1%) women failed laser therapy, while 15 (5.4%) women failed cryotherapy. While treatment failure occurred only in the presence of HPV infection (P = 0.036), failure was not related to infection by a specific genotype. Therapy failure was associated with treatment for CIN II (RR 4.157) and CIN III (RR 2.053) relative to CIN I and treatment of large lesions (P = 0.014).

Conclusion: The determination of the relative area occupied by cervical lesions may have prognostic value in identifying women who are at risk for treatment failure.