Validation of a prediction model for residual disease in patients conized by microinvasive and high-grade lesions
Keywords:
residual disease, conizationAbstract
The diagnosis and treatment of postcone residual disease is not considered standardized due to the lack of prediction models adjusted to the characteristics and needs of the national context, particularly in young patients, without satisfied parity or not eligible for hysterectomy. A prospective descriptive study was carried out to validate a prediction model of post-cone residual disease in the 209 patients coniced by microinvasive and high-grade lesions on the Isle of Youth, between the period 2020-2023. The study constitutes an external validation of the model designed by the authors between 2014 and 2019 and is based on a classification tree that includes three variables: human papillomavirus infection, the state of the surgical edges and the depth of the cone. In this study, the variables showed a significant risk association, with an odds ratio of 6.2; 5.8 and 4.2; respectively. The model showed a sensitivity of 78.1%, a specificity of 93.8% and an efficacy of 91.4%. When including other significant variables such as the presence of glandular lesion and the largest area and degree of lesion, the sensitivity increased to 90.3% and the efficacy to 93.3%. The proposed model is considered relevant for use in clinical practice.
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