scholarly journals Analysis of Conization Results in Patients undergoing Hysterectomy for Uterine Adenocarcinoma

2020 ◽  
Vol 42 (05) ◽  
pp. 266-271
Author(s):  
Denise Gasparetti Drumond ◽  
Isabel Cristina Gonçalves Leite ◽  
Vivian de Oliveira Rodrigues ◽  
Gabriel Duque Pannain ◽  
Miralva Aurora Galvão Carvalho ◽  
...  
Keyword(s):  
Residual Disease ◽  
Common Knowledge ◽  
Epidemiological Data ◽  
Observational Research ◽  
Histopathological Analysis ◽  
Adenocarcinoma In Situ ◽  
Cold Knife ◽  
Multifocal Disease ◽  
Histopathological Result

Abstract Objective To observe if the histopathological result of a conization performed after cervical adenocarcinoma in situ diagnosis is compatible with the histopathological analysis of a subsequent hysterectomy. Methods The present descriptive and observational research consisted of the analysis of the medical records of 42 patients who were diagnosed with in situ adenocarcinoma postconization. The analysis consisted of whether there was compatibility between the histopathological reports of conization and hysterectomy and if there was an association between adenocarcinoma in situ and another neoplasia (squamous disease). Interpretation of any immunohistochemistry reports obtained was also performed. In addition, clinical and epidemiological data were also analyzed. Results A total of 42 conizations were performed, 33 (79%) were cold knife conizations and 9 (21%) were loop electrosurgical excision procedures (LEEPs). Of the patients analyzed, 5 (10%) chose not to undergo subsequent hysterectomy to preserve fertility or were < 25 years old. Out of the 37 patients with adenocarcinoma in situ who underwent subsequent hysterectomy, 6 (16%) presented with residual disease. This finding proved incompatible with the finding of the conizations, which had ruled out invasive cancer. Conclusion The prevalence of adenocarcinoma in situ increased in the past years. There is still a large part of the medical literature that advocates the use of conservative treatment for this disease, even though it is common knowledge that it is a multifocal disease. However, the majority of studies advocate that hysterectomy should remain the preferred treatment for women who have already completed their reproductive purpose.

scholarly journals Risk of residual disease and invasive carcinoma in women treated for adenocarcinoma in situ of the cervix

2013 ◽  
Vol 129 (3) ◽  
pp. 513-516 ◽  
Author(s):  
Anthony B. Costales ◽  
Andrea M. Milbourne ◽  
Helen E. Rhodes ◽  
Mark F. Munsell ◽  
John J. Wallbillich ◽  
...  
Keyword(s):  
Invasive Carcinoma ◽  
Residual Disease ◽  
Adenocarcinoma In Situ

Cervical conization of adenocarcinoma in situ: a predicting model of residual disease

2014 ◽  
Vol 210 (4) ◽  
pp. 366.e1-366.e5 ◽  
Author(s):  
Katherine E. Tierney ◽  
Paul S. Lin ◽  
Charles Amezcua ◽  
Koji Matsuo ◽  
Wei Ye ◽  
...  
Keyword(s):  
Residual Disease ◽  
Adenocarcinoma In Situ ◽  
Predicting Model ◽  
Cervical Conization

Cervical conization of adenocarcinoma in-situ: A predicting model of residual disease

2011 ◽  
Vol 123 (2) ◽  
pp. 429-430
Author(s):  
K.E. Tierney ◽  
P.S. Lin ◽  
C. Amezcua ◽  
K. Matsuo ◽  
Y. Wei ◽  
...  
Keyword(s):  
Residual Disease ◽  
Adenocarcinoma In Situ ◽  
Predicting Model ◽  
Cervical Conization

scholarly journals Prevalence, Predictive Factors and Nomogram of Residual Disease Following Cervical Conization for Adenocarcinoma in Situ

2021 ◽  
Vol 6 (3) ◽  
pp. 317-322
Author(s):  
Boonyapipat Sathana ◽  
Sukkasame Pichamon
Keyword(s):  
Multivariate Analysis ◽  
Predictive Factors ◽  
Residual Disease ◽  
Statistical Significance ◽  
Individual Risk ◽  
Management Decision ◽  
P Value ◽  
Adenocarcinoma In Situ ◽  
Invasive Adenocarcinoma

Objectives: To evaluate the prevalence of residual disease after conization in AIS women, and to develop a nomogram for predicting residual disease in such patients. Methods: Eighty-three cervical adenocarcinoma in situ (AIS) patients were retrospectively reviewed. Patient data concerning: demographic characteristics, colposcopic findings and diagnosis, type of conization, size of pathologic specimens, pathological characteristics, endocervical curettage (ECC) pathology and subsequent procedures, were collected. The rate of residual disease after conization and predictive factors for residual disease in subsequent hysterectomy were analyzed, and a predictive nomogram for residual disease was developed, based on the multivariate analysis results. The statistical significance was set at a p-value of <0.05.Results: The prevalence of residual disease in hysterectomy specimens following conization was 31.8%. Five (5.7%) women with AIS, who underwent subsequent hysterectomy, were found to have invasive adenocarcinoma. According to the multivariate analysis results, the predictive factors for residual disease were a positive endocervical margin status [OR 22.5 (95% CI 4.74, 106.79)] and a depth of specimen of < 8 mm [OR 8.11 (95% CI 1.12, 58.95)]. A nomogram for the prediction of residual disease in AIS women was developed, based on these predictive factors. After bootstrapping 1000 times, the bootstrap-corrected concordance index value for predicting residual disease was 0.852. Conclusion: The residual disease was found in 31.8% of hysterectomy specimens after conization for AIS. Residual disease was strongly associated with a positive endocervical margin and a depth of specimen of <8 mm. This study reports a feasible nomogram, with an acceptable level of accuracy for predicting the individual risk of residual disease; which may be beneficial in proper management decision-making.  

Residual disease and invasive carcinoma in women undergoing hysterectomy for adenocarcinoma in situ (AIS) of the cervix

2012 ◽  
Vol 125 ◽  
pp. S53
Author(s):  
A. Costales ◽  
A. Milbourne ◽  
H. Rhodes ◽  
M. Munsell ◽  
J. Wallbillich ◽  
...  
Keyword(s):  
Invasive Carcinoma ◽  
Residual Disease ◽  
Adenocarcinoma In Situ

scholarly journals Excisional treatment in women with cervical adenocarcinoma in situ (AIS): a prospective randomised controlled non-inferiority trial to compare AIS persistence/recurrence after loop electrosurgical excision procedure with cold knife cone biopsy: protocol for a pilot study

BMJ Open ◽  
2017 ◽  
Vol 7 (8) ◽  
pp. e017576 ◽  
Author(s):  
Paul A Cohen ◽  
Alison Brand ◽  
Peter Sykes ◽  
David C H Wrede ◽  
Orla McNally ◽  
...  
Keyword(s):  
Scientific Journal ◽  
Cervical Screening ◽  
Excisional Biopsy ◽  
Adenocarcinoma In Situ ◽  
Invasive Adenocarcinoma ◽  
Cone Biopsy ◽  
Cold Knife ◽  
Loop Electrosurgical Excision ◽  
Loop Electrosurgical Excision Procedure

IntroductionAdenocarcinoma in situ (AIS) of the uterine cervix is the precursor to invasive endocervical adenocarcinoma. An excisional biopsy such as a cold knife cone biopsy (CKC) should be performed to exclude invasive adenocarcinoma. Loop electrosurgical excision procedure (LEEP) is an alternative modality to CKC but is controversial in AIS. There is a perception that there is a greater likelihood of incomplete excision of AIS with LEEP because the depth of excised tissue tends to be smaller and the tissue margins may show thermal artefact which can interfere with pathology assessment. In the USA, guidelines recommend that any treatment modality can be used to excise AIS, provided that the specimen remains intact with interpretable margins. However, there are no high-quality studies comparing LEEP with CKC and well-designed prospective studies are needed. If such a study were to show that LEEP was non-inferior to CKC for the outcomes of post-treatment persistence, recurrence and adenocarcinoma, LEEP could be recommended as an appropriate treatment option for AIS in selected patients. This would benefit women because, unlike CKC, LEEP does not require general anaesthesia and may be associated with reduced morbidity.Methods and analysisThe proposed exploratory study is a parallel group trial with an allocation ratio of 2:1 in favour of the intervention (LEEP: CKC). Participants are women aged ≥18 to ≤45 years diagnosed with AIS on cervical screening and/or colposcopically directed biopsy in Australia and New Zealand, who are to receive excisional treatment in a tertiary level centre.Ethics and disseminationEthical approval for the study has been granted by the St John of God Healthcare Human Research Ethics Committee (reference number #1137). Results from the study will be presented at conferences and published in a peer-reviewed scientific journal.RegistrationANZCTR registration number ACTRN12617000132347https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=372173&isReview=true

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