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Residual Disease Following Conization of Women with Stage IA-IB1 Cervical Carcinoma in a High Incidence Region

  • Chatchotikawong, Usanee (Gynecologic Oncology Division, Department of Obstetrics & Gynecology, Faculty of Medicine, Siriraj Hospital, Mahidol University) ;
  • Ruengkhachorn, Irene (Gynecologic Oncology Division, Department of Obstetrics & Gynecology, Faculty of Medicine, Siriraj Hospital, Mahidol University) ;
  • Leelaphatanadit, Chairat (Gynecologic Oncology Division, Department of Obstetrics & Gynecology, Faculty of Medicine, Siriraj Hospital, Mahidol University)
  • Published : 2014.09.15

Abstract

Background: To determine rates of residual disease along with influencing factors in women with stage IA to IB1 cervical carcinoma after conization. Materials and Methods: A retrospective study was conducted of medical records of 198 stage IA to IB1 cervical carcinoma patients who had undergoing cervical conization followed by primary surgical treatment during 2006-2013. Independent factors correlating with residual carcinoma in subsequent surgical specimens were analyzed by stepwise regression analysis. Results: Mean age was 48.9 years. Cone specimens demonstrated free margins in 36 women (18.8%). In case of having disease at margin, high-grade cervical intraepithelial neoplasia (CIN) and carcinoma were evidenced in 58 and 97 women, respectively. Pathology of subsequent specimens revealed residual carcinoma in 78 women (39.4%), high-grade CIN or adenocarcinoma in situ (AIS) in 45 (22.7%), and no residual pathology in 75 (37.9%). Age more than 35 years, postmenopausal status, having symptoms, diseases or invasive lesions at conization margins or disease on endocervical aspect, and higher stage were significantly correlated with residual cancer in surgical treatment specimens. On regression analysis, postmenopause and stage were independent factors associated with residual carcinoma.Conclusions: Patient and tumor characteristics are predictive factors for residual cancer in the studied group of women.

Keywords

Cervix;cervical cancer;conization;residual disease;predicting factor

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