Laser conization of cervical intraepithelial neoplasia grade 3, Free resection margins indicative of lesion-free survival

Bertelsen, Bjørn; Tande, Tormod; Sandvei, Roar; Hartveit, F

doi:10.1080/j.1600-0412.1999.780112.x

Cited by 17 publications

(8 citation statements)

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“…We found, as might be expected, that the probability of being persistence/recurrence-free was significantly higher in the margin-negative cases than in margin-positive ones (p = 0.007 by log-rank test), and this result was quite consistent with that of a previous study [7]. When we looked only at CIN cases which had passed their first test for being cured (those that had a normal cervical cytology at some point during the initial 3-month follow-up, regardless of whether they were judged margin negative or margin positive), we again found that the recurrence-free probability was significantly lower in margin-positive cases than in margin-negative cases (hazard ratio 5.19; 95% CI, 1.175-22.994; p = 0.0041 by log-rank test).…”

Section: Discussionsupporting

confidence: 93%

“…However, others have found that the resection margin of CIN lesions produced by LEEP, cold knife, or laser was demonstrated to be able to aid in predicting the subsequent recurrence of CIN 3 [7,8]. According to Chen et al, the persistence/recurrence rate of margin-positive cases, 33% (47/141 cases), was significantly higher than that of the margin-negative cases, 2% (21/972 cases) (p \ 0.0001 by Fisher's exact test).…”

Section: Discussionmentioning

confidence: 96%

“…Pathological diagnosis of the persistent/recurrent lesion was CIN 1 in three cases (cases 2, 6, 7), CIN 2 in one case (case 3), and CIN 3 in three cases (cases 1,4,8). Among these margin-negative cases, the first cytology exhibited normal appearance (NILM) and the CIN lesions were detected beyond the initial 3 months of observation (after 299-2,465 days from conization) in three cases (cases 6,7,8). These cases were regarded to be recurrences.…”

Section: Persistent/recurrent Cases After Conizationmentioning

confidence: 92%

“…In addition, the median follow-up period was not reported in their analysis. The long-term cumulative persistence/recurrence rate, the most important outcome measure of conservative treatment for any pre-malignant lesions, was demonstrated in their report; however, the rate was not compared by the status of their resection margin data, which has been demonstrated elsewhere to be of significant value for the prediction of the outcome of conization procedures for CIN 3 [7,8]. In our present study, the long-term outcome of CIN 3 treated by Shimodaira-Taniguchi conization in our facility was re-analyzed by the status of their resection margins.…”

Section: Introductionmentioning

confidence: 91%

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Prediction, based on resection margins, of long-term outcome of cervical intraepithelial neoplasia 3 treated by Shimodaira-Taniguchi conization

Miyoshi

Miyatake

Ueda

et al. 2011

Arch Gynecol Obstet

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 96%

Section: Persistent/recurrent Cases After Conizationmentioning

confidence: 92%

Section: Introductionmentioning

confidence: 91%

See 2 more Smart Citations

Prediction, based on resection margins, of long-term outcome of cervical intraepithelial neoplasia 3 treated by Shimodaira-Taniguchi conization

Miyoshi

Miyatake

Ueda

et al. 2011

Arch Gynecol Obstet

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show abstract

“…However, it is only recently that LEEP has become the mainstay of treatment of CIN 2 and 3, and the status of the excised tissue is more commonly being included in the histopathology reports (21,49). This topic has been extensively reviewed recently in the Survey (50) Involved margins are accepted as a risk factor for recurrent CIN (51)(52)(53). Other studies found that margin status is not an independent factor for residual disease (48,54).…”

Section: Considering Leep Specimen Margins In Follow-up Protocolmentioning

confidence: 97%

Tools for Post LEEP Surveillance

Bornstein

Schwartz²,

Perri³

et al. 2004

Obstetrical & Gynecological Survey

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Long‐term risk of invasive cervical cancer after treatment of squamous cervical intraepithelial neoplasia

Soutter

Sasieni

Panoskaltsis

2005

Intl Journal of Cancer

202

133

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Invasive cancer of the cervix after treatment for cervical intraepithelial neoplasia (CIN) is becoming more important, as screening reduces the incidence of invasive disease. The rate of invasive cervical or vaginal cancer following treatment for CIN in UK remains elevated for at least 8 years. The aim of our study was to determine from international data how long this rate remains elevated and whether the rate of invasive disease reflects the rate of posttreatment CIN. The aim was to determine why the rate of invasive disease does not fall. A search of Medline and a secondary search of cited references identified 1,848 articles referring to the success rate of the treatment of CIN. Only 26 cohorts from 25 articles met all the inclusion criteria. The policy in these was to perform at least annual smears. After the first year following treatment for CIN, the rate of invasive disease remained about 56 per 100,000 woman years until at least 20 years after treatment. This rate is~2.8 times greater than expected. In contrast, the risk of posttreatment CIN declined steadily with time to about 190 per 100,000 women in the 10th year. Although the posttreatment rate of CIN falls with time, the rate of invasive disease remains static. It seems likely that this is due to diminishing compliance with follow-up. Women should be encouraged to persevere with annual smears for at least 10 years after their treatment as this may offer them the best chance of detecting recurrence at a treatable stage. ' 2005 Wiley-Liss, Inc.Key words: cervical neoplasms; cervical intraepithelial neoplasia; treatment; follow-up; patient compliance Invasive cancer of the cervix occurring after treatment for cervical intraepithelial neoplasia (CIN) is becoming more important, as screening reduces the overall incidence of invasive disease. In 1997, a multicentre UK study of 44,699 women years of followup after conservative treatment of CIN showed that the cumulative rate of invasion after 8 years was 5.8 per 1,000 women and that the rate remained the same throughout the 8-year period such that these women remained at~5 times greater risk than the general population.1 The second edition of the NHS Cervical Screening Programme Guidelines, 2 published in the same year, described the controversy surrounding the optimum duration of annual cytology testing after the treatment of CIN. It also referred to the importance of confirming that the rate of invasive disease did not fall and of investigating the reasons for this continuing high risk.The present study was commissioned by NHS Cervical Screening Programme to undertake an analysis of long-term follow-up studies of women treated for CIN. The first objective was to determine from international data how long the rate of invasive cervical or vaginal cancer following treatment for CIN remains elevated. The second objective was to establish whether the rate of invasive disease was a reflection of the rate of posttreatment CIN. The aim was to investigate the reasons for the continuing high risk of invasive dis...

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Laser conization of cervical intraepithelial neoplasia grade 3, Free resection margins indicative of lesion-free survival

Cited by 17 publications

References 0 publications

Prediction, based on resection margins, of long-term outcome of cervical intraepithelial neoplasia 3 treated by Shimodaira-Taniguchi conization

Prediction, based on resection margins, of long-term outcome of cervical intraepithelial neoplasia 3 treated by Shimodaira-Taniguchi conization

Tools for Post LEEP Surveillance

Long‐term risk of invasive cervical cancer after treatment of squamous cervical intraepithelial neoplasia

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