Conization as only treatment of carcinoma in situ of the uterine cervix

Bjerre, Bo; Eliasson, Gösta; Linell, F; Söderberg, Hanna; Sjöberg, Nils‐Otto

doi:10.1016/0002-9378(76)90584-6

Cited by 87 publications

(19 citation statements)

References 9 publications

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“…Di Saia and Creasman[24] reported that the surgical treatment including cold-knife excision, electrocautery, cryosurgery and laser ablation achieved high success rates between 90 and 98%. Recurrence rate of conization for CIN was reported to be 0.6% [25,26,27]. From these findings, PDT may be somewhat inferior to surgical treatment for CIN.…”

Section: Discussionmentioning

confidence: 77%

Photodynamic Therapy for Cervical Intraepithelial Neoplasia

Yamaguchi¹,

Tsuda²,

Takemori³

et al. 2005

Oncology

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Objectives: Photodynamic therapy (PDT) is a minimally invasive treatment for cervical intraepithelial neoplasia (CIN). We report the effectiveness of PDT in 105 cases of CIN. Methods: All patients received photofrin (PHE) 2 mg/kg intravenously and, 48–60 h later, phototherapy was performed using the Excimer dye laser or a YAG-OPO laser with an irradiation dose of 100 J/cm² using 630 nm wavelength. Results: Mild photosensitivity occurred in 48% (50/105) of patients. The complete response (CR) rate was 90% (94/105) at 3 months following treatment. In the remaining 11 patients, 5 patients had CIN1, 2 patients had CIN2, and 4 patients had mild cytologic findings. However, in 9 of these 11 patients, CR was achieved 6 months after PDT. In 69 patients, human papilloma virus (HPV) typing was performed before and after PDT therapy. Pre-treatment, 64 of 69 patients (93%), were HPV-positive including 30 cases of high-risk HPV (43%). Testing performed 3, 6 and 12 months following PDT revealed no HPV-DNA in 75% (52/69), 74% (48/65) and 72% (41/57) of patients. At present, the median follow-up period is 636 days (90–2,232 days). In 3 patients, recurrence requiring surgical treatment was identified at 646, 717 and 895 days after PDT. Conclusions: PDT is an effective and minimally invasive treatment for CIN, which also appears to eradicate HPV infection.

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Section: Discussionmentioning

confidence: 77%

Photodynamic Therapy for Cervical Intraepithelial Neoplasia

Yamaguchi¹,

Tsuda²,

Takemori³

et al. 2005

Oncology

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“…The line of resection studied may not be precisely the actual cut sur face because of an oblique section, or there may be loss of tissue during the technical preparation [9,10]. Other fac tors are related to the surgical procedure itself and the pro cess of wound healing.…”

Section: Discussionmentioning

confidence: 99%

Persistent Cervical Intraepithelial Neoplasia after Incomplete Conization: Predictive Value of Clinical and Histological Parameters

Jansen

Trimbos²,

Hermans³

et al. 1994

Gynecol Obstet Invest

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In a group of 316 conizations performed from January 1984 to July 1991, 68 patients (22%) revealed no free margins of cervical intraepithelial neoplasia (CIN). They were divided into two groups with: ‘negative follow-up’ [normal cytology or less than two smears suggesting CIN I (class IIIa)] and ‘positive follow-up’ [at least two smears suggesting CIN I or one smear suggesting CIN II (class IIIb) or worse]. Forty-five patients (66%) fulfilled the criteria of negative follow-up. All patients with CIN I at the cone margin (18) were found in this group. The other 23 patients were in the positive follow-up group. Patients with positive follow-up were significantly younger (p = 0.04). Intervention after incomplete cone biopsy was necessary in approximately 10% (7/68) of cases. Cytology was thereby a reliable indicator for residual disease. Higher grade of CIN involved at the cone margin predicted a higher chance of positive follow-up. Semiquantitative measurement of CIN in the cone specimen showed a severe involvement of CIN II and CIN III in the positive follow-up group. In sum, our study showed that CIN I at the margin of the cone biopsy has no clinical significance. However, CIN II or III at the margin needs a careful cytologic follow-up, and appropriate action should be taken in case of cytologic abnormalities.

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“…Asi, analizando los tratamientos por estadios, encontramos que en el carcinoma de cérvix in situ se acepta que el tratamiento quirúrgico es el más adecuado, prefiriéndose la cirugía conservadora (conización, laser, crioterapia) y reservandose la cirugía radical o la radioterapia (braquiterapia ) para casos seleccionados o con contraindicación quirúrgica respectivamente 3,4 . En el estadio IA, dependiendo de la profundidad de la invasión, se acepta como tratamiento de elecion tanto el quirúrgico (conización, histerectomía total, histerectomía radical) como el realizado con radioterapia (braquiterapia) 5 .…”

Section: Discussionunclassified