Conservative treatment of microinvasive squamous cell carcinoma of the cervix stage IA1: Defining conization height to an optimal oncological outcome.

<h4>Objective</h4>This paper searches an ideal cone height for stage definition and safe treatment of cervical microinvasive squamous carcinoma stage IA1 (MIC IA1), avoiding excessive cervix resection, favoring a future pregnancy.<h4>Methods</h4>A retrospective study was perf...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Caio A Hartman, Joana F Bragança, Maria Salete C Gurgel, Luiz C Zeferino, Liliana A L A Andrade, Julio C Teixeira
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/3a12efda45ff4165997f29e1b8e442a6
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:3a12efda45ff4165997f29e1b8e442a6
record_format	dspace
spelling	oai:doaj.org-article:3a12efda45ff4165997f29e1b8e442a62021-12-02T20:09:05ZConservative treatment of microinvasive squamous cell carcinoma of the cervix stage IA1: Defining conization height to an optimal oncological outcome.1932-620310.1371/journal.pone.0253998https://doaj.org/article/3a12efda45ff4165997f29e1b8e442a62021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0253998https://doaj.org/toc/1932-6203<h4>Objective</h4>This paper searches an ideal cone height for stage definition and safe treatment of cervical microinvasive squamous carcinoma stage IA1 (MIC IA1), avoiding excessive cervix resection, favoring a future pregnancy.<h4>Methods</h4>A retrospective study was performed involving 562 women with MIC IA1, from 1985 to 2013, evaluating cone margin involvement, depth of stromal invasion, lymph vascular invasion, conization height, and residual uterine disease (RD). High-grade squamous lesions or worse detection was considered recurrence. Univariate and multivariate regression analyses were performed, including age, conization technique (CKC, cold-knife, or ETZ, excision of transformation zone), and pathological results. Conization height to provide negative margins and the risk of residual disease were analyzed.<h4>Results</h4>Conization was indicated by biopsy CIN2/3 in 293 cases. Definitive treatments were hysterectomy (69.8%), CKC (20.5%), and ETZ (9.7%). Recurrence rate was 5.5%, more frequent in older women (p = 0.030), and less frequent in the hysterectomy group (p = 0.023). Age ≥40 years, ETZ and conization height are independent risk factors for margin involvement. For ages <40 years, 10 mm cone height was associated with 68.6% Negative Predictive Value (NPV) for positive margins, while for 15 mm and 25 mm, the NPV was 75.8% and 96.2%, respectively. With negative margins, the NPV for RD varied from 85.7-92.3% for up to 24 mm cone height and 100% from 25 mm.<h4>Conclusion</h4>Conization 10 mm height for women <40 years provided adequate staging for almost 70%, with 10% of RD and few recurrences. A personalized cone height and staging associated with conservative treatment are recommended.Caio A HartmanJoana F BragançaMaria Salete C GurgelLuiz C ZeferinoLiliana A L A AndradeJulio C TeixeiraPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 7, p e0253998 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Caio A Hartman Joana F Bragança Maria Salete C Gurgel Luiz C Zeferino Liliana A L A Andrade Julio C Teixeira Conservative treatment of microinvasive squamous cell carcinoma of the cervix stage IA1: Defining conization height to an optimal oncological outcome.
description	<h4>Objective</h4>This paper searches an ideal cone height for stage definition and safe treatment of cervical microinvasive squamous carcinoma stage IA1 (MIC IA1), avoiding excessive cervix resection, favoring a future pregnancy.<h4>Methods</h4>A retrospective study was performed involving 562 women with MIC IA1, from 1985 to 2013, evaluating cone margin involvement, depth of stromal invasion, lymph vascular invasion, conization height, and residual uterine disease (RD). High-grade squamous lesions or worse detection was considered recurrence. Univariate and multivariate regression analyses were performed, including age, conization technique (CKC, cold-knife, or ETZ, excision of transformation zone), and pathological results. Conization height to provide negative margins and the risk of residual disease were analyzed.<h4>Results</h4>Conization was indicated by biopsy CIN2/3 in 293 cases. Definitive treatments were hysterectomy (69.8%), CKC (20.5%), and ETZ (9.7%). Recurrence rate was 5.5%, more frequent in older women (p = 0.030), and less frequent in the hysterectomy group (p = 0.023). Age ≥40 years, ETZ and conization height are independent risk factors for margin involvement. For ages <40 years, 10 mm cone height was associated with 68.6% Negative Predictive Value (NPV) for positive margins, while for 15 mm and 25 mm, the NPV was 75.8% and 96.2%, respectively. With negative margins, the NPV for RD varied from 85.7-92.3% for up to 24 mm cone height and 100% from 25 mm.<h4>Conclusion</h4>Conization 10 mm height for women <40 years provided adequate staging for almost 70%, with 10% of RD and few recurrences. A personalized cone height and staging associated with conservative treatment are recommended.
format	article
author	Caio A Hartman Joana F Bragança Maria Salete C Gurgel Luiz C Zeferino Liliana A L A Andrade Julio C Teixeira
author_facet	Caio A Hartman Joana F Bragança Maria Salete C Gurgel Luiz C Zeferino Liliana A L A Andrade Julio C Teixeira
author_sort	Caio A Hartman
title	Conservative treatment of microinvasive squamous cell carcinoma of the cervix stage IA1: Defining conization height to an optimal oncological outcome.
title_short	Conservative treatment of microinvasive squamous cell carcinoma of the cervix stage IA1: Defining conization height to an optimal oncological outcome.
title_full	Conservative treatment of microinvasive squamous cell carcinoma of the cervix stage IA1: Defining conization height to an optimal oncological outcome.
title_fullStr	Conservative treatment of microinvasive squamous cell carcinoma of the cervix stage IA1: Defining conization height to an optimal oncological outcome.
title_full_unstemmed	Conservative treatment of microinvasive squamous cell carcinoma of the cervix stage IA1: Defining conization height to an optimal oncological outcome.
title_sort	conservative treatment of microinvasive squamous cell carcinoma of the cervix stage ia1: defining conization height to an optimal oncological outcome.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/3a12efda45ff4165997f29e1b8e442a6
work_keys_str_mv	AT caioahartman conservativetreatmentofmicroinvasivesquamouscellcarcinomaofthecervixstageia1definingconizationheighttoanoptimaloncologicaloutcome AT joanafbraganca conservativetreatmentofmicroinvasivesquamouscellcarcinomaofthecervixstageia1definingconizationheighttoanoptimaloncologicaloutcome AT mariasaletecgurgel conservativetreatmentofmicroinvasivesquamouscellcarcinomaofthecervixstageia1definingconizationheighttoanoptimaloncologicaloutcome AT luizczeferino conservativetreatmentofmicroinvasivesquamouscellcarcinomaofthecervixstageia1definingconizationheighttoanoptimaloncologicaloutcome AT lilianaalaandrade conservativetreatmentofmicroinvasivesquamouscellcarcinomaofthecervixstageia1definingconizationheighttoanoptimaloncologicaloutcome AT juliocteixeira conservativetreatmentofmicroinvasivesquamouscellcarcinomaofthecervixstageia1definingconizationheighttoanoptimaloncologicaloutcome
_version_	1718375117711474688

Conservative treatment of microinvasive squamous cell carcinoma of the cervix stage IA1: Defining conization height to an optimal oncological outcome.

Ejemplares similares