Long-term quality of life assessment after excisional treatment for cervical dysplasia

Sparić, Radmila; Bukumirić, Zoran; Stefanović, Radomir; Tinelli, Andrea; Kostov, Stoyan; Watrowski, Rafał

doi:10.1080/01443615.2022.2083486

Cited by 6 publications

(4 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…These together cause significant direct and indirect costs for the healthcare system and entire society. Moreover, worries about impaired reproductive performance lead to overall diminished HRQoL in women of reproductive age treated by cervical excision (7,11).…”

Section: Overview Of Perinatal Complicationsmentioning

confidence: 99%

“…An increased risk of perinatal complications following cervical conization was demonstrated during the last century (6). Furthermore, surgical treatment of cervical premalignant lesions is associated with additional long-term morbidity in terms of the impairment of psycho-social and emotional well-being, changes in sexual life, which all additionally diminish reproductive outcomes and health-related quality of life (HRQoL) in women affected by cervical dysplasia during reproductive years (7)(8)(9)(10)(11)(12)(13)(14).…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Perinatal complications following excisional treatment of cervical dysplasia

Sparić,

Anđić,

Plešinac

et al. 2023

Medicinska istraživanja

Self Cite

View full text Add to dashboard Cite

Cervical cancer is one of the most common malignant tumors in women. Mass screenings have significantly decreased its incidence, while causing an increase in precancerous cervical lesions that are mainly diagnosed in women of reproductive age who still have not fulfilled their reproductive goals. The aim of surgical treatment of these premalignant lesions is to prevent the development of cervical cancer, with minimal risks to the reproductive function. The most important perinatal complication is preterm delivery, usually coupled with preterm premature rupture of the membranes and chorioamnionitis. This results in prematurity with low birth weights, which can further result in increased neonatal morbidity and mortality. Data on the incidence of spontaneous miscarriages in treated women are non-consistent , however, it is believed that the incidence is higher in the second trimester. Possible predictors of complications are the amount of excised tissue, the type of excision technique, age at the time of surgery, and the length of the period between treatment and conception. Re-excision of the cervix is an additional risk factor for perinatal complications. The risk of perinatal complications is the highest after cold knife conization, followed by laser conization, whereas LEETZ excision means the lowest risk-this is primarily explained by the variations in the cone size. Having in mind that not all precancerous cervical lesions progress to cancer and that all types of excision treatments are associated with an increased incidence of perinatal complications, an adequate approach would entail primarily well-selected patients, i.e., treating only those women who are at real risk of developing cancer. The surgical treatment must be adapted to provide minimal risks for perinatal complications, maximal oncologic safety , and minimal risk of residual and/or recurring disease during a woman's lifespan.

show abstract

Section: Overview Of Perinatal Complicationsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Perinatal complications following excisional treatment of cervical dysplasia

Sparić,

Anđić,

Plešinac

et al. 2023

Medicinska istraživanja

Self Cite

View full text Add to dashboard Cite

show abstract

“…to infertility; (4) women with clear contraindications for natural delivery before pregnancy; (5) Women with other major diseases.…”

Section: Plos Onementioning

confidence: 99%

“…To avoid missing early or latent cervical cancer, the objective of the therapy was to thoroughly eradicate the lesion and prevent its transformation into cancer. Previous studies identified the women may suffer from impaired emotional well-being and reduced quality of life [ 5 ] even in early stage of cervical cancer and the fertility is also damaged by fertility-sparing surgery [ 6 ] or cervical conization [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

The effect of cold-knife conization on pregnancy outcomes in patients with cervical lesions

Gao¹,

Wang²,

Xiao³

2022

PLoS ONE

View full text Add to dashboard Cite

Objective To analyze the pregnancy outcomes of patients with cervical lesions treated by cold-knife conization (CKC). Methods Clinical data of healthy pregnant women and pregnant women who underwent CKC in Dalian Women and Children’s Medical Group from March 2010 to December 2019 were retrospectively analyzed. These patients were divided into a CKC group and a control group according to inclusion and exclusion criteria. Statistical methods were used to compare pregnancy and delivery outcomes between the two groups. Results There were 400 patients in CKC group and control group, with 200 patients in each. There was no significant difference in the mode of delivery, abortion, ectopic pregnancy, in-hospital perinatal management, and cervical cerclage between the CKC group and the control group (P>0.05). The rates of preterm delivery, premature rupture of membranes, cesarean section, and neonatal admission in the CKC group were higher than those in the control group (P<0.05). In the CKC group, the incidence of premature rupture of membranes within six months postoperatively was higher than that after six months (P<0.05). The incidences of preterm delivery and premature rupture of membranes were not completely consistent in different conization ranges (P<0.05). Conclusion CKC increases the incidence of preterm delivery, premature rupture of membranes, and neonatal adverse outcomes. Conization height can predict the occurrence of preterm delivery. Delaying pregnancy after surgery can reduce the incidence of adverse outcomes during the perinatal period.

show abstract

Predictive models for personalized precision medical intervention in spontaneous regression stages of cervical precancerous lesions

He,

Zhu,

Zhou

et al. 2024

J Transl Med

View full text Add to dashboard Cite

Background During the prolonged period from Human Papillomavirus (HPV) infection to cervical cancer development, Low-Grade Squamous Intraepithelial Lesion (LSIL) stage provides a critical opportunity for cervical cancer prevention, giving the high potential for reversal in this stage. However, there is few research and a lack of clear guidelines on appropriate intervention strategies at this stage, underscoring the need for real-time prognostic predictions and personalized treatments to promote lesion reversal. Methods We have established a prospective cohort. Since 2018, we have been collecting clinical data and pathological images of HPV-infected patients, followed by tracking the progression of their cervical lesions. In constructing our predictive models, we applied logistic regression and six machine learning models, evaluating each model’s predictive performance using metrics such as the Area Under the Curve (AUC). We also employed the SHAP method for interpretative analysis of the prediction results. Additionally, the model identifies key factors influencing the progression of the lesions. Results Model comparisons highlighted the superior performance of Random Forests (RF) and Support Vector Machines (SVM), both in clinical parameter and pathological image-based predictions. Notably, the RF model, which integrates pathological images and clinical multi-parameters, achieved the highest AUC of 0.866. Another significant finding was the substantial impact of sleep quality on the spontaneous clearance of HPV and regression of LSIL. Conclusions In contrast to current cervical cancer prediction models, our model’s prognostic capabilities extend to the spontaneous regression stage of cervical cancer. This model aids clinicians in real-time monitoring of lesions and in developing personalized treatment or follow-up plans by assessing individual risk factors, thus fostering lesion spontaneous reversal and aiding in cervical cancer prevention and reduction. Graphical Abstract

show abstract

Long-term quality of life assessment after excisional treatment for cervical dysplasia

Cited by 6 publications

References 26 publications

Perinatal complications following excisional treatment of cervical dysplasia

Perinatal complications following excisional treatment of cervical dysplasia

The effect of cold-knife conization on pregnancy outcomes in patients with cervical lesions

Predictive models for personalized precision medical intervention in spontaneous regression stages of cervical precancerous lesions

Contact Info

Product

Resources

About