Laser CO2 conization in postmenopausal age: risk of cervical stenosis and unsatisfactory follow-up

Penna, Carlo; Fambrini, Massimiliano; Fallani, Maria Grazia; Pieralli, Annalisa; Scarselli, Gianfranco; Marchionni, M

doi:10.1016/j.ygyno.2004.11.012

Cited by 52 publications

(40 citation statements)

References 14 publications

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“…This observation leads to assume that menopausal and postmenopausal age at the time of conization represents a risk factor, also due to involution of cervical tissue for the lack of sexual hormones. The correlation between patient's age at the time of treatment and the stenosis of cervical canal was also recognized by the working group of University of Florence and was described in previous works [30]. Considering our series, patient's age appears the main risk factor for stenosis: patients (3/60) in which this complication occurred were respectively 49, 52 (both in menopausal phase) and 72 years old (post-menopausal phase).…”

Section: Doi: 107243/2052-6210-1-3supporting

confidence: 77%

The efficacy of long term follow-up and CO2 laser conization as conservative management in patients with cervical cancer stage FIGO IA1

Fallani¹,

Pieralli²,

Lozza³

et al. 2013

Gynecol

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Background: Patients with FIGO (International Federation of Gynaecologists and Obstetricians) stage IA1 cervical squamous carcinoma can be treated conservatively with conization only as alternative to a hysterectomy. The aim of this study was to evaluate the efficacy of laser CO 2 excision as therapeutical method for stage IA1 cervical squamous carcinoma. Methods: Sixty patients were submitted to CO 2 laser conization with histologic diagnosis of squamous carcinoma stage FIGO IA1 and then submitted to follow-up with PAP smear, colposcopy and biopsy. Prognostic risk factors for relapse were evaluated with univariate analysis. Results: Conservative management with laser therapy was effective in more than 90% of the patients. When disease persistence was detected (7%), patients underwent repeated laser CO 2 conization and followed-up without demolitive intervention. The risk of disease progression in the case series was 1.8%. Univariate analysis revealed that only depth of stromal invasion was a significant risk factor for relapse (P<0.04). Moreover, depth of stromal invasion between 1-3 mm was the only prognostic factor for relapse with specificity 78%, sensitivity 75% and likelihood positive ratio 3,47. Conclusion: Laser CO 2 conization alone appeared to be an effective and safe treatment for patients with Cervical Cancer Stage FIGO IA1 if careful post-treatment follow-up was guaranteed. The deph of stromal invasion has been confirmed as the most important risk and prognostic factor to be evaluated for disease relapse.

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Section: Doi: 107243/2052-6210-1-3supporting

confidence: 77%

The efficacy of long term follow-up and CO2 laser conization as conservative management in patients with cervical cancer stage FIGO IA1

Fallani¹,

Pieralli²,

Lozza³

et al. 2013

Gynecol

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“…Nonetheless, no statistically significant difference was observed (p = 0.68). Penna et al 7 evaluated age, parity, menopause, time of menopause, hormone replacement therapy (HRT) and previous surgical procedures in the cervix as risk factors for cervical stenosis following laser conization. …”

Section: Discussionmentioning

confidence: 99%

“…Because of the different defi nitions used, the incidence observed by each author has also varied (from 0 to 25.9%). [7][8][9][10] Better knowledge regarding this complication of electrosurgical conization of the cervix would enable the planning of prevention strategies.…”

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confidence: 99%

Cervical stenosis following electrosurgical conization

et al. 2008

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CONTEXT AND OBJECTIVE: Cervical stenosis is a postoperative complication of procedures for treating preinvasive lesions of the cervix and takes on particular importance due to the clinical repercussions associated with it. Furthermore, it causes limitations in relation to cytological and colposcopic follow-up. The aim here was to assess the incidence of cervical stenosis among a cohort of patients who underwent electrosurgical conization and to identify possible prognostic factors associated with its occurrence. DESIGN AND SETTING:Retrospective study at Gynecology and Obstetrics Department, Instituto Fernandes Figueira, Rio de Janeiro. METHODS:This was an observational study among a cohort of patients who underwent electrosurgical conization of the uterine cervix. The possible predictive variables were analyzed as bivariate means between the groups with and without stenosis. We also calculated the incidence density rate ratio for cervical stenosis in relation to each possible predictive variable and the respective confi dence intervals (95%). Levels of 5% were considered signifi cant.RESULTS: 274 patients who underwent electrosurgical conization of the uterine cervix with a minimum follow-up period of six months were included. The crude incidence of cervical stenosis was 7.66% and the incidence density was 3.3/1,000 patients-month. CONCLUSIONS:We did not fi nd associations between the variables for stenosis. However, we observed borderline signifi cance levels relating to hemorrhagic complications before and after the operation (p = 0.089).

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“…Eine Zervikalstenose nach Konisation kommt in etwa 7 % der Fälle vor [3,4]. Eine Hämatozervix ist in der Literatur nur in wenigen Fallbeispielen beschrieben [2,5].…”

Section: Diskussionunclassified

Sekundäre Amenorrhoe, Schmierblutungen und Schmerzen nach Konisation

Popovici

2015

Gynäkologische Endokrinologie

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Laser CO2 conization in postmenopausal age: risk of cervical stenosis and unsatisfactory follow-up

Cited by 52 publications

References 14 publications

The efficacy of long term follow-up and CO2 laser conization as conservative management in patients with cervical cancer stage FIGO IA1

The efficacy of long term follow-up and CO2 laser conization as conservative management in patients with cervical cancer stage FIGO IA1

Cervical stenosis following electrosurgical conization

Sekundäre Amenorrhoe, Schmierblutungen und Schmerzen nach Konisation

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