Correlation of recurrence rates and times with posttreatment human papillomavirus status in patients treated with loop electrosurgical excision procedure conization for cervical squamous intraepithelial lesions

Prato, Bruno del; Ghelardi, Alessandro; Gadducci, Angiolo; Marchetti, Ivo; Cristofano, Claudio Di; Coscio, G Di; Bevilacqua, Generoso; Genazzani, Andrea Riccardo

doi:10.1111/j.1525-1438.2007.00965.x

Cited by 54 publications

(34 citation statements)

References 30 publications

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“…most of the studies demonstrate that the margins affections increase the risk of illness residual [24,25] significantly. In the study of Houfflin-Debargue et al [26] the patients with positive margins were 36%, in the study of Serati et al [27], 32% of the patients presented margins affections and it was found that this was the factor more important predictor of recurrent illness, the same as in the works of Prato [28] and Baloglu et al [29].…”

Section: Design Methodologicalsupporting

confidence: 59%

Factors predictors of residual illness in patient conizadas for lesions micro invaders and of high degree

Gómez¹,

Rodríguez²

2017

Clin Obstet Gynecol Reprod Med

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In Cuba, the cervical cancer constitutes an important problem of health for its high indexes of morbi-mortality and emotional impact in the population. In the handling of the women with their lesions precursors, the objective consists on preventing the possible progression to cancer invader without sobretratar the lesions with high regression probabilities. Along the time different treatments and protocols have been proven in order to obtaining the best results in the control of this pathology with conservative techniques, in the face of the growing incidence in patient without satisfied parity and minimizing the possibility of residual illness. It was carried out a prospective descriptive study to determine the relationship between the diagnosis of residual illness and clinical-epidemic factors in 428 patients with lesions cervical epithelial of high degree that were conization in the Hospital General Educational Heroes of the Baire during the period 2014-2016. 53% of the studied patients was bigger than 35 years of age, 74% had one or two children, 20% smoked, 38% had an initial cytology of high degree, 46% they had a lesion with an area of 100-199mm2, 90% they were conization for handle diathermic and 29% they were conization for not correlation diagnostics. The surgical margins affected by lesion, the carcinoma histology in situ or micro invader, the area of more lesion 199mm2 and the glandular lesions of the cervical channel constituted factors predictors of residual illness. The presence of these factors predictors meant 79,6% of probability of appearance of residual lesion.

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Section: Design Methodologicalsupporting

confidence: 59%

Factors predictors of residual illness in patient conizadas for lesions micro invaders and of high degree

Gómez¹,

Rodríguez²

2017

Clin Obstet Gynecol Reprod Med

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“…[1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16] The high sensitivity of the HPV test (typically 95-100%) means that a negative HPV test result is a highly certain indicator of effective treatment (ie. high negative predictive value).…”

Section: Introductionmentioning

confidence: 99%

A whole-population profile of HPV testing as a test of cure for high-grade cervical dysplasia in NSW, Australia

Morrell

Qian

2014

J Med Screen

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Introduction: Few population-based studies have been conducted on the efficacy of human papilloma virus (HPV) testing as a test of cure for high grade cervical dysplasia. Methods: A cohort of women (n ¼ 11,521) with high grade (CIN2þ) cervical dysplasia diagnosed during 2006-2010, who also had accompanying HPV testing (n ¼ 19,434 HPV tests), was analyzed with respect to National Health and Medical Research Council (NHMRC) follow-up guidelines. Cure rates, and number of follow-up tests and times to reach a cure were estimated. Results: In the 52-years following high grade dysplasia, 53% of women had a single follow-up HPV test, 33% had two, and 14% had three or more HPV follow-up tests. 75% of women with follow-up HPV and cytology testing according to NHMRC guidelines were cured (2,210 from 2,948). Cure rates were lowest in those aged <30 (71%) and highest in women aged 30-49 (80%). Of those cured, 68% attained cure by the second HPV test, 21% by the third, and 11% at the fourth or later HPV test. The median time to cure was 1,097 days. In non-cured women, 56% of test results originated from all-negative cytology with positive HPV, compared with 9% from all-negative HPV results. Conclusions: Cure rates in women with follow-up testing according to NHMRC guidelines are high. Further studies are needed of the high proportion of women with negative cytology classed as not cured due to HPV positivity, and of the high proportion of women with high grade dysplasia who had one follow-up HPV test only.

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“…Being aware of this we must use these tools in the best cost-effective protocol, which will be most accurate in diagnosis and sparing in treatment. Studies have shown a higher sensitivity in detection of residual/recurrent disease with the use of combined testing (cytology and HPV) [5,6]. Combined testing raises the cost of follow-up and in some countries like Croatia, with a tradition of high quality cytology this is unacceptable.…”

Section: Introductionmentioning

confidence: 99%

The Value of HPV-HR DNA Testing During the Follow-Up After Treatment of CIN3/AIS

Banović

Mahovlić

Salopek

et al. 2014

Pathol. Oncol. Res.

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There is still debate on what is the optimal follow-up protocol after a treatment for preinvasive cervical disease. We performed this study in order to improve diagnostic accuracy of the follow-up protocol and at the same time reducing the number of overtreated patients. One hundred and fourteen patients were followed up after conization for CIN3 and/or AIS at 3-6 month, 9-12 month and 18-24 month intervals, then yearly. The follow-up consisted of cytology, colposcopy with biopsy if needed and HPV testing. The end-point of the study was a secondary treatment due to a high suspicion of resdidual/recurrent disease or disease free period of at least 24 months. The median follow-up time was 41 months (5-72 months). In predicting residual/recurrent disease cytology had a specificity of 88.9%, sensitivity of 100%, PPV of 33.3% and a NPV of 100% whereas HPV had a specificity of 76.9%, sensitivity of 100%, PPV of 21.4% and a NPV of 100%. According to our results both tests can be used as a primary follow-up tool after conization. The choice should depend on a socio-economic aspect. In our setting the HPV test should be done only in those patients with a positive smear any time during follow-up as the point of decision for a second treatment. With this approach we could considerably decrease the number of reoperated patients and co-morbidities.

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Correlation of recurrence rates and times with posttreatment human papillomavirus status in patients treated with loop electrosurgical excision procedure conization for cervical squamous intraepithelial lesions

Cited by 54 publications

References 30 publications

Factors predictors of residual illness in patient conizadas for lesions micro invaders and of high degree

Factors predictors of residual illness in patient conizadas for lesions micro invaders and of high degree

A whole-population profile of HPV testing as a test of cure for high-grade cervical dysplasia in NSW, Australia

The Value of HPV-HR DNA Testing During the Follow-Up After Treatment of CIN3/AIS

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