The effect of local photodynamic therapy with 5-aminolevulinic acid in the treatment of positive margin after cervical conization

Positive margins after cervical conization are associated with residual and recurrent lesions. This study evaluates the efficacy and safety of 5-aminolevulinic acid photodynamic therapy (ALA-PDT) in treating patients with positive margins. A retrospective analysis of 36 patients with positive margins treated with ALA-PDT was conducted. All patients were followed up at 3, 6, 9, and 12 months, and every six months thereafter. At 6-month follow-up, the rates of lesions complete remission (CR) and HPV clearance were 83.3% and 63.9%, respectively. The factors of age, HPV subtypes, TCT results, positive margin locations, gland involvement, and primary conization method did not affect CR or HPV clearance. Only one patient had recurrent cervical HSIL over two years. ALA-PDT is effective for treating positive margins after cervical conization, reducing residual lesion and recurrence risks without further cervical harm. It is suitable for most patients with positive margins.