Conization for Preinvasive and Early Invasive Carcinoma of the Uterine Cervix

Larsson, Göran

doi:10.3109/00016348309155362

Cited by 18 publications

(16 citation statements)

References 213 publications

(64 reference statements)

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“…Compared with the figures given in the literature (60% to 94%) our results are excellent (Ahlgren et al 1975, Kolstad et al 1976, Burghardt et al 1980, Larsson 1983. After therapeutic conization, persistent neoplasia has been found in 3.2 to 9.1% of patients (Ahlgren et al 1975, Kolstad et al 1976, Burghardt et al 1980, Larsson 1983. Cure rates were higher in the series in which conization was the preferred form of therapy and colposcopy was used in the preoperative evaluation as in our study (Ahlgren et al 1975, Kolstad et al 1986).…”

Section: Discussionsupporting

confidence: 70%

“…The overall accuracy rate in our study was comparable to the 62 to 96% in the literature review published by Helmerhorst et al in 1987. In the present series the frequency of complete excision by conization was 94%. Compared with the figures given in the literature (60% to 94%) our results are excellent (Ahlgren et al 1975, Kolstad et al 1976, Burghardt et al 1980, Larsson 1983. After therapeutic conization, persistent neoplasia has been found in 3.2 to 9.1% of patients (Ahlgren et al 1975, Kolstad et al 1976, Burghardt et al 1980, Larsson 1983.…”

Section: Discussionsupporting

confidence: 67%

“…In the literature the recurrence rate of CIN is higher after incomplete excision by conization than after complete excision (9.5%-30% and 0.3%-2.9%, respectively) (Ahlgren et al 1975, Kolstad et al 1976, Burghardt et al 1980, Larsson 1983. In our series the recurrence of CIN was 1/110 (0.9%), but the follow-up time is short as compared to those in the literature (Ahlgren et al 1975, Kolstad et al 1976).…”

Section: Discussioncontrasting

confidence: 48%

“…For many years, hysterectomy and conization have been the preferred treatments for high-grade CIN (Ahlgren et al 1975, Kolstad et al 1976, Burghardt et al 1980, Larsson 1983). The increasing frequency with which CIN is seen among the young calls for a more conservative approach.…”

Section: Discussionmentioning

confidence: 99%

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Conization for CIN associated with human papillomavirus infection

Yliskoski

Saarikoski

Syrjänen

1991

Arch Gynecol Obstet

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We report results of follow-up by PAP smears and colposcopy in 116 women treated since 1981 by conization for cervical intraepithelial neoplasia with human papillomavirus infection (HPV-CIN). The mean follow-up time was 31.9 (SD 19) months. Preoperative diagnosis was HPV-CIN II (with extension into the endocervix) in 11 cases and HPV-CIN III in 103 cases; two diagnostic conizations were performed. The histological examination of the cone biopsies showed complete excision of CIN in 109 cases (94%). Three patients underwent hysterectomy after conization; one had microinvasion in the cone biopsy, one had suspicion of microinvasion and one had non-radical conization. Three patients (2.6%) were lost to follow-up. After excluding these six patients the primary cure rate of HPV lesions (normal cytological and colposcopical finding after conization) was 82.7%. Four patients (4.6%) had residual CIN after conization. During the follow-up 15 patients had recurrence of HPV infection, only one had HPV-CIN I. HPV 16 was the most common HPV type (56/116, 48.2%) in the conization group and also in the recurrent cases (9/15, 60%). The results support the role of HPV 16 in cervical carcinogenesis.

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Section: Discussionsupporting

confidence: 70%

Section: Discussionsupporting

confidence: 67%

Section: Discussioncontrasting

confidence: 48%

Section: Discussionmentioning

confidence: 99%

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Conization for CIN associated with human papillomavirus infection

Yliskoski

Saarikoski

Syrjänen

1991

Arch Gynecol Obstet

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“…Worldwide, cervical conization is a frequently per formed procedure for diagnostic and therapeutic pur poses [1]. Conization is mostly used as a therapeutic alternative to hysterectomy in patients with cervical in traepithelial neoplasia (CIN) who are considered unsuit able for local destructive therapy after colposcopic assess ment.…”

Section: Introductionmentioning

confidence: 99%

Persistent Cervical Intraepithelial Neoplasia after Incomplete Conization: Predictive Value of Clinical and Histological Parameters

Jansen

Trimbos²,

Hermans³

et al. 1994

Gynecol Obstet Invest

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In a group of 316 conizations performed from January 1984 to July 1991, 68 patients (22%) revealed no free margins of cervical intraepithelial neoplasia (CIN). They were divided into two groups with: ‘negative follow-up’ [normal cytology or less than two smears suggesting CIN I (class IIIa)] and ‘positive follow-up’ [at least two smears suggesting CIN I or one smear suggesting CIN II (class IIIb) or worse]. Forty-five patients (66%) fulfilled the criteria of negative follow-up. All patients with CIN I at the cone margin (18) were found in this group. The other 23 patients were in the positive follow-up group. Patients with positive follow-up were significantly younger (p = 0.04). Intervention after incomplete cone biopsy was necessary in approximately 10% (7/68) of cases. Cytology was thereby a reliable indicator for residual disease. Higher grade of CIN involved at the cone margin predicted a higher chance of positive follow-up. Semiquantitative measurement of CIN in the cone specimen showed a severe involvement of CIN II and CIN III in the positive follow-up group. In sum, our study showed that CIN I at the margin of the cone biopsy has no clinical significance. However, CIN II or III at the margin needs a careful cytologic follow-up, and appropriate action should be taken in case of cytologic abnormalities.

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Surgery for cervical intraepithelial neoplasia

Martin-Hirsch

Paraskevaidis

Bryant

et al. 2013

Cochrane Database of Systematic Reviews

182

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Background-Cervical intraepithelial neoplasia (CIN) is the most common pre-malignant lesion. Atypical squamous changes occur in the transformation zone of the cervix with mild, moderate or severe changes described by their depth (CIN 1, 2 or 3). Cervical intraepithelial neoplasia is treated by local ablation or lower morbidity excision techniques. Choice of treatment depends on the grade and extent of the disease.Objectives-To assess the effectiveness and safety of alternative surgical treatments for CIN.Search methods-We searched the Cochrane Gynaecological Cancer Group Trials Register, Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library), MEDLINE and EMBASE (up to April 2009). We also searched registers of clinical trials, abstracts of scientific meetings and reference lists of included studies.Selection criteria-Randomised controlled trials (RCTs) of alternative surgical treatments in women with cervical intraepithelial neoplasia.Data collection and analysis-Two review authors independently abstracted data and assessed risks of bias. Risk ratios that compared residual disease after the follow-up examination and adverse events in women who received one of either laser ablation, laser conisation, large loop excision of the transformation zone (LLETZ), knife conisation or cryotherapy were pooled in random-effects model meta-analyses.

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Conization for Preinvasive and Early Invasive Carcinoma of the Uterine Cervix

Cited by 18 publications

References 213 publications

Conization for CIN associated with human papillomavirus infection

Conization for CIN associated with human papillomavirus infection

Persistent Cervical Intraepithelial Neoplasia after Incomplete Conization: Predictive Value of Clinical and Histological Parameters

Surgery for cervical intraepithelial neoplasia

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