Association of preoperative cone biopsy with recurrences after radical hysterectomy

Objective To evaluate association of preoperative cone biopsy with the probability of recurrent disease after radical hysterectomy for cervical cancer. Methods This is a retrospective single-center study. Patients with cervical cancer stage IA1 with LVSI to IIA2 and squamous, adenosquamous and adenocarcinoma subtype were included. Patients were analyzed for general characteristics and recurrence-free survival (RFS). Results In total, of 480 patients with cervical cancer, 183 patients met the inclusion criteria (117 with laparoscopic and 66 with open surgery). The median tumor diameter was 25.0 mm (range 4.6–70.0 mm) with 66 (36.2%) patients having tumors smaller than 2 cm. During median follow-up of 54.0 months (range 0–166.0 months), the RFS for the laparoscopic cohort was 93.2% and 87.5% at 3 and 4.5 years, and 79.3% for the open cohort after 3 and 4.5 years, respectively. In total, 17 (9.3%) patients developed recurrent disease, 9 (7.3%) after laparoscopic, and 8 (12.1%) after open surgery. No preoperative cone biopsy (OR 9.60, 95% CI 2.14–43.09) as well as tumor diameter > 2 cm (OR 5.39, 95% CI 1.20–24.25) were significantly associated with increased risk for recurrence. In multivariate analysis, only missing preoperative cone biopsy was significantly associated with increased risk for recurrence (OR 5.90, 95% CI 1.11–31.29) Conclusion There appears to be a subgroup of patients (preoperative cone biopsy, tumor diameter < 2 cm) with excellent survival and low risk for recurrence after radical hysterectomy which might benefit from the advantages of laparoscopic surgery.

A BRIEF REVIEW ON CRYOGUN MACHINE FOR PRE-CERVIX CANCER HEALING

Cervical cancer is generally found in women of all ages due to virus infection on epithelial cells of female cervix. It is known that a certain type of Human Papilloma Virus (HPV) is suspected to cause cervix cancer in women from various ethnics. Several therapies have been used to cure cancer diseases like cone biopsy, laser treatment, electrosurgical excision, thermocoagulation, ablation therapy, and cryotherapy. This paper has highlighted on the role of cryogun machine applied in cryotherapy for pre-cervical cancer treatment in relation to freezing technique using liquid nitrogen to kill cancer cells on infectious area.

Association of Preoperative Cone Biopsy With Recurrences After Radical Hysterectomy

ObjectiveTo evaluate association of preoperative cone biopsy with the probability of recurrent disease after radical hysterectomy for cervical cancer.MethodsThis is a retrospective single-center study. Patients with cervical cancer stage IA1 with LVSI to IIA2 and squamous, adenosquamous and adenocarcinoma subtype were included. Patients were analyzed for general characteristics and recurrence-free survival (RFS). ResultsIn total, of 480 patients with cervical cancer 183 patients met the inclusion criteria (117 with laparoscopic and 66 with open surgery). The median tumor diameter was 25.0 mm (range 4.6-70.0 mm) with 66 (36.2%) patients having tumors smaller than 2 cm. During median follow-up of 54.0 months (range 0-166.0 months) the RFS for the laparoscopic cohort was 93.2% and 87.5% at 3 and 4.5 years, and 79.3% for the open cohort after 3 and 4.5 years, respectively. In total, 17 (9.3%) patients developed recurrent disease, 9 (7.3%) after laparoscopic, and 8 (12.1%) after open surgery. No preoperative cone biopsy (OR 9.60, 95%CI 2.14-43.09) as well as tumor diameter >2cm (OR 5.39, 95%CI 1.20-24.25) were significantly associated with increased risk for recurrence. In multivariate analysis only missing preoperative cone biopsy was significantly associated with increased risk for recurrence (OR 5.90, 95% CI 1.11-31.29)ConclusionThere appears to be a subgroup of patients (preoperative cone biopsy, tumor diameter <2cm) with excellent survival and low risk for recurrence after radical hysterectomy which might benefit from the advantages of laparoscopic surgery.

REVIEW OF MEDICAL DESCRIPTION OF CERVICAL CYTOLOGY

Cervical cancer is a malignant neoplasm of the cervical area or cervix which may present with the vaginal bleeding but symptoms may be absent until the cancer gets in advanced stage. Dysplasia seen on cervical biopsy uses the term cervical intraepithelial neoplasia (CIN) and is grouped into mild (CIN-1), moderate (CIN-2) and severe (CIN-3). The severity of CIN depends upon cellular disorganization, cellular immaturity, increased mitotic activity and nuclear abnormalities. The nuclear atypia, extent of mitotic activity and immature cellular proliferations identifies the degree of dysplasia. Thus, epithelial thickness which shows differentiation is the useful feature in decision about severity of CIN. Treatment of this cancer may be ablative and/ or excision. Cryotherapy is a reasonable treatment of CIN-1 and CIN-2 but not of CIN-3 which is severe cervical carcinoma. Burning the TZ-transformation zone (Electro diathermy) destroys the tissue more effectively than that of cryotherapy but it usually requires general anesthesia, however laser cold coagulations technique requires local anesthesia usually. Laser TZ Excision compromises the fertility. Knife cone biopsy is used as a preferred treatment for removal of abnormal cervical cells. Now the cone biopsy is generally performed using the laser surgery. Early diagnosis of cervical cancer is very necessary for better control and treatment of it. For early phases of cervical carcinoma, the cryotherapy is very reasonable, however in case of late stage of the disease laser methods are used alone or on combination. Therapy will be termed successful if cytology remains negative after at least six months of its treatment.