Recurrence and therapeutic problems in cervical dysplasia and in situ cancer

Michalkiewicz, W; Przybora, L; Simm, S; Wolna, Magda

doi:10.1002/1097-0142(196309)16:9<1212::aid-cncr2820160911>3.0.co;2-y

Cited by 4 publications

(6 citation statements)

References 5 publications

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“…15,23,[36][37][38] There were no papers concentrating exclusively on women who had CIN I or CIN II, the majority of papers considered follow up after carcinoma in situ or CIN III. 22,[24][25][26][27]29,[30][31][32][33][34][35]39 Data extraction Table 2 summarises the abstracted data from all 19 included papers. Cytological nomenclature has changed over time, and reports from early studies have been 'translated' into the currently accepted terminology to allow for comparison.…”

Section: Resultsmentioning

confidence: 99%

“…Three of the papers contained information about women who had more than one histological diagnosis 23,24,28 Five papers followed up women after hysterectomy for benign disease 15,23,36–38 . There were no papers concentrating exclusively on women who had CIN I or CIN II, the majority of papers considered follow up after carcinoma in situ or CIN III 22,24–27,29,30–35,39 …”

Section: Resultsmentioning

confidence: 99%

“…more adverse outcomes with increased severity of disease. 26 7.5 810 64 64/810 Gemmell et al 22 9 219 9 9/219 Kalogirou et al 29 7.5 793 210 210/793 Pearce et al 15 7 5682 79 79/5682 Piscitelli et al 37 6 697 33 33/697 Videlefsky et al 38 7 25 8 2849 24 24/2 849 Fawdry 26 7.5 810 12 12/810 Gemmell et al 22 9 219 3 3/219 Kalogirou et al 29 7.5 793 41 41/793 Michalkiewicz et al 35 6.5 172 2 0/12 2/160 Pearce et al 15 7 5682 5 5/5682 Piscitelli et al 37 6 697 2 2/697 Videlefsky et al 38 7. Follow up after hysterectomy for benign histology Table 4a contains details of all studies reporting follow up after hysterectomy for benign reasons with follow-up information irrespective of methodological quality.…”

Section: Discussionmentioning

confidence: 99%

“…15 Follow up after hysterectomy for CIN III This diverse group of 15 papers only included six of better methodological quality. 22,[24][25][26]29,35 Three papers included cases of CIN I and CIN II, in addition to CIN III; 24,28,29 one paper also included benign cases, but comprised a population of women who were HIV positive-a population not comparable with the general population and therefore excluded from further analysis. 23 The six best quality papers were published over more than a 40-year span, and their recommendations changed over time; in the earliest paper, the conclusion was 'of the utmost importance is thorough and long-term follow up', while the most recent stated 'The highest incidence of VAIN is found in the first 2 years after hysterectomy, after that incidence falls to that of the general prehysterectomy population.'…”

Section: Selection Of and Distribution Of Diseasementioning

confidence: 99%

“…Kalogirou et al; 29 Kirkup et al; 29 Liukko et al; 31 McIndoe et al; 33 Michalkiewicz et al;35 Wiener et al39 Williams et al23 excluded as inTable 4a.…”

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confidence: 99%

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Systematic review: Vaginal vault smears after hysterectomy for reasons other than malignancy: a systematic review of the literature

Stokes-Lampard

Wilson

Waddell

et al. 2006

BJOG

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Background Vaginal vault smears are used to detect persisting neoplasia of the lower genital tract after hysterectomy. Recent data suggest both widespread use and uncertain evidence of their effectiveness.Objectives To identify and synthesise evidence on the use and effectiveness of vaginal vault smears and to assess the quality. Selection criteria Primary research, women who had a hysterectomy and were followed up by vault cytology.Data collection and analysis Systematic search (eight electronic databases), supplemented by contact with experts and review of bibliographies. Two independent reviewers determined eligibility/ validity and extracted data concerning test performance characteristics. Quality was assessed according to the established criteria.Results Of 441 unique references, only 19 were suitable. Quality of studies varied considerably and few were of 'high' methodological quality. Studies were geographically diverse, and were published over more than 40 years in 16 journals. From the higher scoring papers, there were 11 659 hysterectomies [6546, benign; 76, cervical intraepithelial neoplasia (CIN) I/CIN II; 5037, CIN III]. Proportions of abnormal vault smears and abnormal biopsies during follow up increased with worsening histology at hysterectomy (P < 0.0001 and P = 0.0001). There was only one report of vaginal cancer subsequent to hysterectomy for CIN and insufficient data to allow for reliable meta-analysis.Conclusions Vault smears cause anxiety, consume resources and their value is largely unproven. Inconsistency of study design and limited methodological quality means that the value of vault smears could not be established. High-quality research is required to ensure that the guidelines are evidence based.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Selection Of and Distribution Of Diseasementioning

confidence: 99%

“…Kalogirou et al; 29 Kirkup et al; 29 Liukko et al; 31 McIndoe et al; 33 Michalkiewicz et al;35 Wiener et al39 Williams et al23 excluded as inTable 4a.…”

mentioning

confidence: 99%

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