Outcome after a cytological prediction of glandular abnormality

Mitchell, Heather

doi:10.1111/j.1479-828x.2004.00288.x

Cited by 7 publications

(5 citation statements)

References 10 publications

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“…This result is similar to the findings in our patients with 13 pathological results: nine cases had premalignant lesions (77%) and four cases had malignant cervical, endometrial or extra‐uterine lesions (23%). In a study by Mitchell, less than 1% of women with minor non‐specific change had cancer 14 . In our study, the incidence of cancer was higher than that reported in their.…”

Section: Discussionmentioning

confidence: 99%

Clinical and histological significance of atypical glandular cell on Pap smear

Behtash

Nazari

Fakhrejahani

et al. 2007

Aust NZ J Obst Gynaeco

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Section: Discussionmentioning

confidence: 99%

Clinical and histological significance of atypical glandular cell on Pap smear

Behtash

Nazari

Fakhrejahani

et al. 2007

Aust NZ J Obst Gynaeco

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“…For women with possible high-grade glandular or minor nonspecific changes on Pap smear they found these rates to be 5% and < 1%, respectively. 13 In our study 42 women were referred with AIS on Pap smear and 4 (10%) were diagnosed with an adenocarcinoma in addition to AIS on histology. Thirty-three women had a possible high-grade glandular lesion on their referral Pap smear, 12 with a coexisting high-grade squamous lesion.…”

Section: Correlation Cytology and Histologymentioning

confidence: 72%

“…In a study conducted in Victoria (Australia) 16% of women with AIS on cytology were diagnosed with cancer on histology. 13 This is a high rate in comparison with women with squamous carcinoma in situ on cytology, among whom cancer is diagnosed in about 3-4%. For women with possible high-grade glandular or minor nonspecific changes on Pap smear they found these rates to be 5% and < 1%, respectively.…”

Section: Correlation Cytology and Histologymentioning

confidence: 99%

Effect of treatment choices for cervical adenocarcinoma in situ on rates of residual disease, recurrence and progression

Theuws

Allen

2017

Southern African Journal of Gynaecological Oncology

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Background: Cervical adenocarcinoma in situ (AIS) is the known precursor condition of cervical adenocarcinoma. The aim of this study is to evaluate treatment choices for AIS in terms of residual disease, recurrence and progression to invasive cancer. Methods: This is a retrospective cohort study conducted at the Mercy Hospital for Women in Melbourne, Australia. Women diagnosed with AIS on histology between 2000 and 2013 were included. Patient records were reviewed for notes on symptoms, cytology, colposcopy and biopsy reports, initial treatment, any subsequent treatment, outcome and follow-up. Results: A total of 114 patients were included: 87 patients were treated with one or more fertility-sparing procedures; 25 patients received a subsequent hysterectomy, one a trachelectomy and one chemo-and radiotherapy. Residual disease was found in 31% (9/29) after a previous procedure with positive margins. In 13.3% (2/15) residual disease was diagnosed despite clear surgical margins. The mean follow-up time was 78.6 months (range 7.9-183). Two patients (2/87, 2.3%) who primarily received fertilitysparing treatment had recurrent AIS. None of the patients progressed to invasive cancer. Conclusion: Both positive and negative margins after initial treatment must be carefully considered in each case. With negative margins, fertility-sparing surgery should be a treatment choice available for all women, not only for those who want to preserve fertility. Fertility-sparing surgery requires regular follow-up.

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“…For older women (aged >45 years), a more extensive excision is recommended (at least 25–35 mm) . In this subgroup, 47% (9/19) had an excision of ≤15 mm.…”

Section: Resultsmentioning

confidence: 99%

“…This study confirms the relatively high risk of invasive cancer in women with AIS predicted by cervical cytology, 19.3% in this study. This figure is consistent with national data . Given the high risk of invasive disease associated with index cytology predicting AIS, at a population level, this degree of noncompliance is concerning.…”

Section: Discussionmentioning

confidence: 99%

RANZCOG Fellows’ adherence to guidelines following cytological prediction of cervical adenocarcinoma‐in‐situ: Cause for concern?

Powell

Cohen

Spilsbury

et al. 2018

Aust NZ J Obst Gynaeco

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Background:For Australian women with screen-detected adenocarcinoma-insitu (AIS), an excisional biopsy is mandatory for further assessment, treatment, and to exclude the presence of cervical adenocarcinoma. The only exclusion to this rule is if the woman has a clinically evident invasive cervical malignancy.Excisional treatments should be tailored according to a patient's age and future obstetric needs. To date, practitioner compliance with this recommendation has not been investigated.Aims: To investigate clinical management for patients with a cytological test result predicting AIS. Secondary aims were to report the most severe histological findings of excisional biopsy specimens following cytological prediction of AIS and investigate treatment outcomes for conservatively managed patients with biopsy-confirmed AIS. Materials and Methods:A retrospective, population-based cohort study was conducted. Cases were ascertained from the Tasmanian and Western Australia Cervical Screening Registries. Cytology and histology results for women with an index cervical smear reporting AIS from 2001 to 2012 were reviewed.Results: Three hundred and twenty-one women (age range 18-69 years) had an index smear reporting AIS. Cervical cancer was diagnosed in 62 (19.3%) patients within the study cohort. Twenty-one of 321 patients (6.7%) were not initially managed according to the 2005 NHMRC Guidelines for the management of asymptomatic women with screen-detected abnormalities, including two women diagnosed with an occult cancer following a total hysterectomy. Conclusions:A minority of women were not managed in accordance with guidelines. This is of concern given that nearly one in five women with a smear predicting AIS had a final diagnosis of cervical cancer. K E Y W O R D Sadenocarcinoma-in-situ, cervical cytology, guidelines, management

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Outcome after a cytological prediction of glandular abnormality

Abstract: These results can be used to inform an evidence-based approach to the investigation and management of abnormal glandular cytology reports. The results can also be used to better inform women about the significance of their abnormal cytology.

Cited by 7 publications

References 10 publications

Clinical and histological significance of atypical glandular cell on Pap smear

Clinical and histological significance of atypical glandular cell on Pap smear

Effect of treatment choices for cervical adenocarcinoma in situ on rates of residual disease, recurrence and progression

RANZCOG Fellows’ adherence to guidelines following cytological prediction of cervical adenocarcinoma‐in‐situ: Cause for concern?

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