Residual lesions in uterine specimens after loop electrosurgical excision procedure in patients with CIN

Lin, Jing; Wu, Dan; Li, Zhunan; Xü, Ying; Chen, Yi

doi:10.1007/s00404-018-4881-7

Cited by 13 publications

(14 citation statements)

References 25 publications

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“…These studies differ from each other methodologically, including the study populations and analysis of variables. However, similar to our results, studies found that ECC positivity 13,19,20 was a significant risk factor for residual disease. The finding that abnormal ECC results were independently associated with residual lesions in uterine specimens indicates the feasibility of identifying risk factors before conization and may be helpful in pre-procedural planning to optimize clinical management.…”

Section: Dovepresssupporting

confidence: 92%

“…Several previous studies have evaluated clinical and pathological predictors of the persistence of or residual CIN and cervical cancer. 3,[5][6][7][8][9][10][13][14][15][16][17] However, only a few studies have examined whole uterine specimens after hysterectomy 13 and have focused on post-menopausal patients alone. These studies differ from each other methodologically, including the study populations and analysis of variables.…”

Section: Dovepressmentioning

confidence: 99%

“…12 Therefore, to make more appropriate management decisions in clinical practice, many researchers have investigated risk factors that may predict residual disease after treatment for CIN 2-3. 3,[5][6][7][8][9][10][13][14][15][16][17] Some have found that menopausal status 17 and older age (>45 years) 15 are associated with a higher risk for residual disease after cervical conization. This specific group of post-menopausal or older patients needs more attention during treatment.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

<p>Risk Factors for Residual Disease in Hysterectomy Specimens After Conization in Post-Menopausal Patients with Cervical Intraepithelial Neoplasia Grade 3</p>

Sun

Lei

Xie

et al. 2020

IJGM

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Background Post-menopausal patients with cervical intraepithelial neoplasia (CIN) have a high rate of residual or recurrent lesions after treatment, and their risk for cervical cancer later in life is higher than the general population. Hence, management for this specific group of post-menopausal patients needs more attention. Objective The study aimed to identify risk factors associated with the presence of residual disease in hysterectomy specimens in post-menopausal patients with cervical intraepithelial neoplasia grade 3 (CIN 3). Methods This study was a retrospective analysis of data from post-menopausal women who had undergone hysterectomy following conization for CIN 3 from 2012 to 2018 at Fujian Maternity and Child Health Hospital. Factors extracted from the database included age, parity, Thinprep cytology results, human papillomavirus (HPV) genotype, biopsy results, pre-cone endocervical curettage (ECC) results, conization method, operating surgeon, cone dimension, margin status and glandular involvement. Univariate and multivariate analyses were performed to identify risk factors associated with residual disease in hysterectomy specimens. Results Analysis of data from 129 women was performed. The proportion of residual disease was 43.41% overall. A higher grade according to colposcopy biopsy, abnormal pre-cone ECC results, the cone method (LEEP vs CKC), a cone volume >1.57 cm 3 , and positive margins in conization specimens were found to be significantly associated with residual lesions on univariable analysis. After multivariate analysis, only an abnormal pre-cone ECC result (odds ratio 3.99; 95% confidence interval (CI) 1.41–11.33; p = 0.009) remained significant. Conclusion The rate of residual lesions in uterine specimens was high regardless of the cone margin status in post-menopausal women with CIN 3. Risk-based strategies are needed to identify patients who have abnormal pre-cone ECC results, and definitive treatment with hysterectomy should be considered in post-menopausal patients with an elevated risk for residual lesions.

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Section: Dovepresssupporting

confidence: 92%

Section: Dovepressmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

<p>Risk Factors for Residual Disease in Hysterectomy Specimens After Conization in Post-Menopausal Patients with Cervical Intraepithelial Neoplasia Grade 3</p>

Sun

Lei

Xie

et al. 2020

IJGM

View full text Add to dashboard Cite

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“…The results of two previous studies are consistent with our findings to a certain degree, which is noteworthy for us. One is that Lin et al [14] found that an abnormal ECC result was an independent predictor of the risk of residual lesions. The other study reported a similar result regarding preoperative endocervical curettage, which was significantly associated with persistent or recurrent CIN [5].…”

Section: Discussionmentioning

confidence: 99%

An Abnormal Precone Endocervical Curettage Result Is an Independent Risk Factor for Positive Margins in Conization Specimens

Lei

Xie

et al. 2020

Oncol Res Treat

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This study aimed to identify risk factors associated with the presence of positive surgical margins in cervical conization specimens. Methods: This study is a retrospective analysis of data from women who had undergone conization for cervical intraepithelial neoplasia (CIN) from 2012 to 2018 at Fujian Maternity and Child Health Hospital. Factors extracted from the database included age, gravidity, parity, menopausal status, precone Thinprep cytology test, human papillomavirus (HPV) test, precone biopsy, precone endocervical curettage (ECC) result, conization method, operating surgeon, cone dimension, and pathology of the conization specimen, including grade of CIN, margin status and glandular involvement. Univariate and multivariate analyses were performed to identify risk factors associated with positive margins. Results: Data from 495 women were analysed. The proportion of positive margins was 24.85% overall, which varied according to the conization method (27.22% for loop electrosurgical excision procedure vs. 18.52% for cold-knife conization, p = 0.047) and was increased as the severity of the treated lesion increased (10.07% for CIN2 vs. 30.62% for CIN3, p < 0.001). HPV-16 genotype infection, abnormal precone ECC result, higher grade of biopsy, larger cone length and volume, and glandular involvement were significantly associated with positive margins on univariable analysis. After logistic regression analysis, only an abnormal precone ECC result (odds ratio 1.952; 95% confidence interval 1.037-3.676; p = 0.038) remained significant. Conclusions: In the present study, an abnormal precone ECC result was identified as an independent risk factor for positive margins in cervical conization specimens. More aggressive treatment may be considered in patients with abnormal precone ECC results in clinical practice.

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“…③ The presence of residual uterine fibroids was determined by intracavitary color Doppler ultrasonography within 3 weeks after surgery. Diagnostic criteria [ 8 ]: postoperative ultrasonography showed solid hypoechoic nodules with diameter ≥1.0 cm and clear capsule. Patients were asked to go to the hospital for re-examination 3, 6, and 12 months after surgery.…”

Section: Methodsmentioning

confidence: 99%

The Influence of Intraoperative Ultrasound Monitoring on the Risk of Recurrence and Reoperation in Patients with Hysteromyomectomy

Xiang

2022

Contrast Media & Molecular Imaging

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In recent years, with the continuous development and application of minimally invasive methods in China, laparoscopic myomectomy has become the primary method for clinical treatment of uterine fibroids. There is also a high risk of recurrence and reoperation after endoscopic myomectomy. Intraoperative use of ultrasound for auxiliary examination can provide medical staff with spatial information and position information of fibroids and help medical staff to accurately locate the surgical incision. The aim is to investigate the effect of intraoperative ultrasound monitoring on the risk of postoperative recurrence and reoperation in patients undergoing myomectomy. This study retrospectively collected 80 patients who underwent laparoscopic myomectomy in the gynecology department of our hospital from January 2020 to January 2022. According to the different treatment methods, they were divided into a study group and a control group (both n = 40). The control group underwent preoperative ultrasonography and then underwent myomectomy, while the study group underwent both preoperative and intraoperative ultrasonography before undergoing hysterectomy. Myomectomy: all the enrolled patients were followed up by ultrasound after surgery and followed up for 1 year (recheck ultrasound every 3 months). The indicators, postoperative complications, postoperative average diameter of uterine fibroids, postoperative residual rate of uterine fibroids, postoperative recurrence, and reoperation were compared between the two groups. Intraoperative ultrasound monitoring has a significant effect on patients undergoing myomectomy, which can effectively reduce the residual rate of fibroids, completely remove small and deep fibroids, and reduce complications, postoperative recurrence, and reoperation risks. It has good clinical application value.

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Residual lesions in uterine specimens after loop electrosurgical excision procedure in patients with CIN

Cited by 13 publications

References 25 publications

<p>Risk Factors for Residual Disease in Hysterectomy Specimens After Conization in Post-Menopausal Patients with Cervical Intraepithelial Neoplasia Grade 3</p>

<p>Risk Factors for Residual Disease in Hysterectomy Specimens After Conization in Post-Menopausal Patients with Cervical Intraepithelial Neoplasia Grade 3</p>

An Abnormal Precone Endocervical Curettage Result Is an Independent Risk Factor for Positive Margins in Conization Specimens

The Influence of Intraoperative Ultrasound Monitoring on the Risk of Recurrence and Reoperation in Patients with Hysteromyomectomy

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