Asian Pacific Journal of Cancer Prevention

  • 제15권17호
  • /
  • Pages.7383-7387
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  • 2014
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  • 1513-7368(pISSN)
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  • 2476-762X(eISSN)
아시아태평양암예방학회 (Asian Pacific Journal of Cancer Prevention)
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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)
  • 발행 : 2014.09.15
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초록

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.

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참고문헌

  1. Attasara P, Sriplung H (2013). Cancer Incidence in Thailand. in: Khuhaprema T, Attasara P, Sriplung H, Wiangnon S, Sangrajrang S, eds. Cancer in Thailand Vol. VII. Bangkok: Lyon: International Agency for Research on Cancer, 8-76.
  2. Benedet JL, Bender H, Jones H, et al (2000). FIGO staging classifications and clinical practice guidelines in the management of gynecologic cancers. FIGO Committee on Gynecologic Oncology. Int J Gynaecol Obstet, 70, 209-62. https://doi.org/10.1016/S0020-7292(00)90001-8
  3. Bisseling KC, Bekkers RL, Rome RM, Quinn MA (2007). Treatment of microinvasive adenocarcinoma of the uterine cervix: a retrospective study and review of the literature. Gynecol Oncol, 107, 424-30. https://doi.org/10.1016/j.ygyno.2007.07.062
  4. Covens A, Kirby J, Shaw P, Chapman W, Franseen E (1999). Prognostic factors for relapse and pelvic lymph node metastases in early stage I adenocarcinoma of the cervix. Gynecol Oncol, 74, 423-7. https://doi.org/10.1006/gyno.1999.5466
  5. Gien LT, Beauchemin MC, Thomas G (2010). Adenocarcinoma: a unique cervical cancer. Gynecol Oncol, 116, 140-6. https://doi.org/10.1016/j.ygyno.2009.09.040
  6. Hefler LA, Polterauer S, Schneitter A, et al (2010). Repeat surgery in patients with cervical cancer stage FIGO IA1: a series of 156 cases and a review of the literature. Anticancer Res, 30, 565-8.
  7. Hou J, Goldberg GL, Qualls CR, et al (2011). Risk factors for poor prognosis in microinvasive adenocarcinoma of the uterine cervix (IA1 and IA2): a pooled analysis. Gynecol Oncol, 121, 135-42. https://doi.org/10.1016/j.ygyno.2010.11.036
  8. Kodama J, Mizutani Y, Hongo A, et al (2002). Optimal surgery and diagnostic approach of stage IA2 squamous cell carcinoma of the cervix. Eur J Obstet Gynecol Reprod Biol, 101, 192-5. https://doi.org/10.1016/S0301-2115(01)00541-3
  9. Landoni F, Maneo A, Colombo A, et al (1997). Randomised study of radical surgery versus radiotherapy for stage Ib-IIa cervical cancer. Lancet, 350, 535-40. https://doi.org/10.1016/S0140-6736(97)02250-2
  10. Lee JY, Kim HS, Kim K, et al (2014). Safety of less aggressive surgery for stage IA1 squamous cell carcinoma of the cervix. J Obstet Gynaecol Res, 40, 1382-8. https://doi.org/10.1111/jog.12330
  11. Newton M (1975). Radical hysterectomy or radiotherapy for stage I cervical cancer. A prospective comparison with 5 and 10 years follow-up. Am J Obstet Gynecol, 123, 535-42.
  12. Pecorelli S, Zigliani L, Odicino F (2009). Revised FIGO staging for carcinoma of the cervix. Int J Gynaecol Obstet, 105, 107-8. https://doi.org/10.1016/j.ijgo.2009.02.009
  13. Peters WA, 3rd, Liu PY, Barrett RJ, 2nd, et al (2000). Concurrent chemotherapy and pelvic radiation therapy compared with pelvic radiation therapy alone as adjuvant therapy after radical surgery in high-risk early-stage cancer of the cervix. J Clin Oncol, 18, 1606-13.
  14. Phongnarisorn C, Srisomboon J, Khunamornpong S, et al (2006). The risk of residual neoplasia in women with microinvasive squamous cervical carcinoma and positive cone margins. Int J Gynecol Cancer, 16, 655-9. https://doi.org/10.1111/j.1525-1438.2006.00399.x
  15. Poynor EA, Marshall D, Sonoda Y, et al (2006). Clinicopathologic features of early adenocarcinoma of the cervix initially managed with cervical conization. Gynecol Oncol, 103, 960-5. https://doi.org/10.1016/j.ygyno.2006.05.041
  16. Shepherd JH (2012). Cervical cancer. Best Pract Res Clin Obstet Gynaecol, 26, 293-309. https://doi.org/10.1016/j.bpobgyn.2011.12.004
  17. Spoozak L, Lewin SN, Burke WM, et al (2012). Microinvasive adenocarcinoma of the cervix. Am J Obstet Gynecol, 206, 1-6. https://doi.org/10.1016/j.ajog.2011.10.025
  18. Suri A, Frumovitz M, Milam MR, dos Reis R, Ramirez PT (2009). Preoperative pathologic findings associated with residual disease at radical hysterectomy in women with stage IA2 cervical cancer. Gynecol Oncol, 112, 110-3. https://doi.org/10.1016/j.ygyno.2008.09.011
  19. Reynolds EA, Tierney K, Keeney GL, et al (2010). Analysis of outcomes of microinvasive adenocarcinoma of the uterine cervix by treatment type. Obstet Gynecol, 116, 1150-7. https://doi.org/10.1097/AOG.0b013e3181f74062
  20. Roman LD, Felix JC, Muderspach LI, et al (1997). Risk of residual invasive disease in women with microinvasive squamous cancer in a conization specimen. Obstet Gynecol, 90, 759-64. https://doi.org/10.1016/S0029-7844(97)00414-6
  21. Rotman M, Sedlis A, Piedmonte MR, et al (2006). A phase III randomized trial of postoperative pelvic irradiation in Stage IB cervical carcinoma with poor prognostic features: followup of a gynecologic oncology group study. Int J Radiat Oncol Biol Phys, 65, 169-76. https://doi.org/10.1016/j.ijrobp.2005.10.019

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