scholarly journals Margin Status Post Cervical Conization Predicts Residual Adenocarcinoma In Situ (AIS) and Occult Adenocarcinoma in a Predominantly Hispanic Population

Diagnostics ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. 1889
Author(s):  
Linda J. Hong ◽  
Sandy Huynh ◽  
Joy Kim ◽  
Laura Denham ◽  
Mazdak Momeni ◽  
...  
Keyword(s):  
Residual Disease ◽  
Margin Status ◽  
Invasive Cancer ◽  
Comprehensive Cancer Center ◽  
Adenocarcinoma In Situ ◽  
Hispanic Population ◽  
Positive Margins ◽  
Predominantly Hispanic ◽  
Cervical Conization

Background: Adenocarcinoma in situ (AIS) of the cervix, is increasing in incidence, particularly in women of reproductive age. Fertility preservation is often desired. In a predominantly Hispanic population, we sought to determine the incidence of occult cervical cancer co-existing with AIS, and evaluate how conization margin status correlates with residual disease upon hysterectomy. Methods: A retrospective study utilizing a comprehensive cancer center database was conducted. Data from patients with histologically proven AIS of the cervix were abstracted. Results: Of 47 patients that met the criteria, 23 (49%) were Hispanic, 21 (45%) were White, two (4%) were Asian, and one (2%) was Black. The median age was 37. Forty-two patients underwent cervical conizations; 13/42 (48%) had positive margins upon conization; 28/42 (67%) underwent hysterectomies. Furthermore, 6/13 (46%) patients with positive conization margins had residual disease in hysterectomy specimens, with 2/13 (15%) found to have invasive cancer. In contrast, 0/14 (0%) of patients with negative margins had residual disease (p = 0.036, Chi-squared 4.41, df = 1). In total, 2/27 (7%) patients who underwent hysterectomies had invasive cancer (7%). Conclusions: Positive margins upon cervical conization for AIS of the cervix were correlated with a relatively high rate of residual AIS and occult invasive cancer. Negative conization margins were correlated with no residual disease. Those patients may be candidates for fertility-sparing treatment.

Margin status post cervical conization predicts residual adenocarcinoma in situ and occult adenocarcinoma

2021 ◽  
Vol 162 ◽  
pp. S203-S204
Author(s):  
Linda Hong ◽  
Sandy Huynh ◽  
Joy Kim ◽  
Laura Denham ◽  
Yevgeniya Ioffe
Keyword(s):  
Margin Status ◽  
Adenocarcinoma In Situ ◽  
Cervical Conization

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

Predictive value of negative cone margin status for risk of residual disease among women with cervical adenocarcinoma in situ

2012 ◽  
Vol 119 (3) ◽  
pp. 266-269 ◽  
Author(s):  
Chumnan Kietpeerakool ◽  
Surapan Khunamornpong ◽  
Jatupol Srisomboon ◽  
Ajchara Kasunan ◽  
Narisa Sribanditmongkol ◽  
...  
Keyword(s):  
Predictive Value ◽  
Residual Disease ◽  
Margin Status ◽  
Cervical Adenocarcinoma ◽  
Adenocarcinoma In Situ

scholarly journals The value of MR-based radiomics in identifying residual disease in patients with carcinoma in situ after cervical conization

2020 ◽  
Author(s):  
Mengfan Song ◽  
Jing Lin ◽  
Fuzhen Song ◽  
Zhaoxia Qian ◽  
Guangyu Wu ◽  
...  
Keyword(s):  
High Risk ◽  
Carcinoma In Situ ◽  
Residual Disease ◽  
Low Risk ◽  
Uterine Preservation ◽  
Positive Margins ◽  
Imaging Model ◽  
Risk Patients ◽  
Cervical Conization

Abstract PurposeTo develop a magnetic resonance (MR)-based radiomics model for identifying residual disease in patients with carcinoma-in-situ (CIS) after cervical conization.Method110 patients who had CIS after conization and finally underwent hysterectomy were collected to comprise a database to establish an imaging model for predicting the residual status after conization. The imaging features were extracted from the cervical areas around the conization margin, and the performance of the imaging model was compared using different feature selection methods and with that of the pathological positive margins using receiver-operating-characteristic (ROC) analysis. Then, patients who opted for uterine preservation were included and were classified as high-risk or low-risk patients according to the radiomics model. The disease-free survival was compared between the different risk groups using the Kaplan-Meier curve.ResultsThe model with Boruta features achieved an area under the curve (AUC) of 0.889 and an accuracy of 87.3% in the test cohort and significantly outperformed the model created with the random forest method, which had an AUC of 0.701 (p = 0.039), and the positive margins (p = 0.004). Further validation with patients with uterine preservation showed that the patients classified as high risk with the radiomics model were more likely to have tumor recurrence/residual disease in the follow-up period than low-risk patients(p = 0.024).ConclusionsRadiomics can be used to identify residual disease in patients with CIS after cervical conization and could have the potential to predict recurrence in patients who opt for uterine preservation.

scholarly journals Adenocarcinoma in situ of the Cervix – is Loop Electrosurgical Excision Procedure an Acceptable Alternative to Cold Knife Cone Biopsy?

2017 ◽  
Vol 13 (01) ◽  
pp. 24
Author(s):  
Mila Pontremoli Salcedo ◽  
Anthony Costales ◽  
Mark F Munsell ◽  
Preetha Ramalingam ◽  
Ricardo Dos Reis ◽  
...  
Keyword(s):  
Specimen Size ◽  
Margin Status ◽  
Adenocarcinoma In Situ ◽  
Median Length ◽  
Positive Margins ◽  
Specimen Volume ◽  
Cold Knife ◽  
Loop Electrosurgical Excision ◽  
Loop Electrosurgical Excision Procedure

Objective: To compare cone specimen size between loop electrosurgical excision procedure (LEEP) and cold knife cone (CKC), and evaluate the association between specimen size and margin status. Methods/materials: A retrospective review was performed of women with adenocarcinoma in situ (AIS) who underwent CKC or LEEP between 1998 and 2013. Specimen size, including length (distance from the external cervical os to the endocervical margin) and volume were compared between LEEP and CKC, and correlated with margin status. Results: Eighty-five patients underwent a total of 136 procedures, including 91 CKCs (67%) and 45 LEEPs (33%), with 27 removed as a single specimen (one-piece LEEP) and 18 as two specimens with an ectocervical specimen and a deeper endocervical top-hat specimen (two-piece LEEP). The two-piece LEEP specimen median length was significantly longer (2.1 cm) versus CKC (1.4 cm, p<0.01) and one-piece LEEP (0.6 cm, p<0.01). Median specimen volume was greater for two-piece LEEP (7.4 cm3) versus CKC (3.4 cm3, p<0.01) and one-piece LEEP (1.6 cm3, p<0.01). A higher rate of positive margins was noted when comparing all LEEP (67.6%) with CKC specimens (34.2%), p<0.01. However, when the LEEP specimens were analysed separately, one-piece LEEPs had a higher rate of positive margins (81.0%) versus CKC (34.2%) (p<0.01), but there were no significant differences between two-piece LEEP (50.0%) and CKC (34.2%), p=0.26. Conclusion: Our results suggest that a two-piece LEEP produces a larger specimen size with similar rates of positive margins compared with CKC. Given the decreased cost and morbidity compared with CKC, a two-piece LEEP should be considered in the management of women with AIS.

scholarly journals Relationship Between the Size and Margin Status of Ductal Carcinoma In Situ of the Breast and Residual Disease

1997 ◽  
Vol 89 (18) ◽  
pp. 1356-1360 ◽  
Author(s):  
L. Cheng ◽  
N. K. Al-Kaisi ◽  
F. Gebrail ◽  
R. R. Shenk ◽  
N. H. Gordon ◽  
...  
Keyword(s):  
Ductal Carcinoma In Situ ◽  
Carcinoma In Situ ◽  
Ductal Carcinoma ◽  
Residual Disease ◽  
Margin Status

Relationship between Initial Margin Status for Invasive Breast Cancer and Residual Carcinoma after Re-Excision

2007 ◽  
Vol 73 (4) ◽  
pp. 337-343 ◽  
Author(s):  
Cyrus Kotwall ◽  
Mark Ranson ◽  
Anquonette Stiles ◽  
Mary Sue Hamann
Keyword(s):  
Invasive Carcinoma ◽  
Early Stage ◽  
Excisional Biopsy ◽  
Margin Status ◽  
Invasive Cancer ◽  
Positive Margins ◽  
Residual Carcinoma ◽  
Pathology Reports ◽  
Second Procedure ◽  
The Relationship

Little data exists addressing the relationship between initial margin status in a specimen from an excisional biopsy and the presence of residual carcinoma in a subsequent specimen from lumpectomy or mastectomy. We sought to determine the relationship between initial margin status and the presence of residual invasive cancer, and to identify any relationship to other variables. This study was a retrospective review of pathology reports of 582 early-stage invasive duct carcinomas with open excisional biopsies. The initial specimen was classified into one of six margin categories: multiply focally positive (n = 174), focally positive (n = 132), margins <1 mm (n = 98), margins 1 to 2 mm (n = 20), margins >2 mm (n = 46), and margins undetermined (n = 90). All patients had a subsequent definitive second procedure. Pathology reports from the second procedure revealed the presence of residual invasive cancer by initial margin status as follows: in 30 per cent of the initial procedures with multiply focally positive margins, in 22 per cent with focally positive margins, in 8 per cent, 15 per cent, and 4 per cent with margins of <1 mm, 1 to 2 mm, and >2 mm, respectively, and in 28 per cent with undetermined margins. Women with palpable tumors, larger tumor size, and positive axillary nodes were more likely to have multiply focal and focally positive margins. Multiply focally positive and focally positive margins had similar residual invasive carcinoma rates and should be re-excised. All clear margins were equivalent; thus, re-excision was not necessary.

Predictors of residual disease after breast-conserving surgery.

2012 ◽  
Vol 30 (27_suppl) ◽  
pp. 168-168
Author(s):  
Sanjay Aneja ◽  
Donald R. Lannin ◽  
Brigid K. Killelea ◽  
Nina Ruth Horowitz ◽  
Anees B. Chagpar
Keyword(s):  
Tumor Size ◽  
Lymphovascular Invasion ◽  
Residual Disease ◽  
Breast Conserving Surgery ◽  
Invasive Disease ◽  
Invasive Cancer ◽  
Outcome Variable ◽  
Routine Practice ◽  
Breast Cancers

168 Background: Locoregional failure after breast conserving surgery (BCS) is often due to undetected residual disease, and the risk of such residual disease frequently guides management. We sought to determine clinical and pathologic factors correlating with the finding of residual invasive cancer and/or DCIS in patients undergoing BCS. Methods: We performed a retrospective cohort study for all invasive and in situ breast cancer treated with BCS at a single institution in 2009. The main outcome variable of interest was residual disease determined by pathologic examinations of cavity shave margins or reexcision. Chart review and statistical analyses were performed to evaluate clinical and pathological factors correlating with residual DCIS or invasive cancer. Results: 256 in situ or invasive breast cancers were treated with BCS in 2009. Of these, 207 (80.9%) underwent additional resection either for close margins or as routine practice. These formed the cohort of interest for this study. 39 patients (18.8%) had residual DCIS and 22 (10.6%) had residual invasive disease. Age, race, histology, ER, PR, her-2-neu and margin distance for invasive disease did not predict the finding of residual DCIS nor invasive cancer. Lymphovascular invasion, while not predicting residual DCIS, was correlated with the finding of residual invasive disease (28.0% vs. 7.9%, p=0.007). Margin distance for DCIS was not predictive of residual invasive cancer but was predictive of residual DCIS. 33.8% of lesions with DCIS margins <1mm were associated with residual DCIS, while 3.4% of those with DCIS margins >5mm were associated with residual in situ disease (p=0.002). Increasing tumor size for invasive and in situ disease were associated with residual DCIS (median 19.5 vs. 13.0 mm, p=0.001 and 22.5 vs. 15.0 mm, p<0.001, respectively); however, neither size component was associated with residual invasive disease. Conclusions: While margin distance and tumor size are associated with residual DCIS in patients undergoing BCS, these are not correlated with residual invasive disease. Conversely, the finding of lymphovascular invasion predicts residual invasive cancer, but not DCIS. These factors may aid in risk stratification of patients and guide postoperative management.

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