Outcomes of Women Undergoing Excision of the Retained Cervix After Supracervical Hysterectomy

McHale, M.; Smith, Anna Jo Bodurtha; Fader, Amanda N.; Wethington, Stephanie L.

doi:10.1097/aog.0000000000004360

Cited by 3 publications

(1 citation statement)

References 18 publications

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“…About 6% of the patients experience a cyclic bleeding of the cervical stump after LASH as a long-term complication [ 5 ]. A subsequent excision of the cervical stump is associated with a high risk of complications such as perioperative bleeding and gastrointestinal injuries [ 10 ].…”

Section: Discussionmentioning

confidence: 99%

Advanced cervical stump cancer after laparoscopic subtotal hysterectomy: a case report of imaging, laparoscopic staging and treatment approach

Andrikos¹,

Andrikos²,

Naem

et al. 2023

BMC Women's Health

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Background Advanced cancer of the cervical stump, occurring years after a laparoscopic supracervical hysterectomy (LASH), is a rare but serious clinical condition. Many patients who undergo a LASH are unaware of this possible complication. Upon diagnosis of advanced cervical stump cancer, a holistic approach including imaging, laparoscopic surgery and multimodal oncological therapy is required. Case presentation A 58-year-old patient presented to our department with the suspicion of advanced cervical stump cancer eight years after LASH. She reported pelvic pain, irregular vaginal bleedings and irregular discharge. Gynaecological examination revealed a locally advanced tumor of the uterine cervix with suspicion of infiltration of the left parametria and bladder. After thorough diagnostic imaging and laparoscopic staging, the tumor stage was determined as FIGO IIIB and the patient was treated with combined radiochemotherapy. The patient presented with tumor recurrence 5 months after the completion of therapy and she is currently being treated with multichemotherapy and immunotherapy regimens as palliative treatment. Conclusion Patients should be made aware about the risk of cervical stump carcinoma after LASH and the necessity for regular screening. Cervical cancer after LASH is often diagnosed at advanced stages and the treatment requires an interdisciplinary approach.

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Section: Discussionmentioning

confidence: 99%

Advanced cervical stump cancer after laparoscopic subtotal hysterectomy: a case report of imaging, laparoscopic staging and treatment approach

Andrikos¹,

Andrikos²,

Naem

et al. 2023

BMC Women's Health

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Cervical Cancer Stage at Diagnosis and Survival among Women ≥65 Years in California

Cooley

Maguire

Morris

et al. 2023

Cancer Epidemiology, Biomarkers &Amp; Prevention

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Background: Through adequate screening and follow-up, cervical cancer can be prevented or detected at early-stage (stage I), which is related to excellent survival. Current guidelines recommend discontinuing screening for women ≥65 years with history of normal Pap and/or HPV tests, potentially leaving this age group vulnerable. This study examined late-stage disease in a population-based cohort. Methods: Using California Cancer Registry data, we identified 12,442 patients ages ≥21 years with a first primary cervical cancer diagnosed during 2009–2018. Proportions of late-stage disease (stages II–IV) and early- and late-stage 5-year relative survival are presented by the age group. Among patients ages ≥65 years, multivariable logistic regression estimated associations of sociodemographic and clinical characteristics with late-stage cervical cancer. Results: Nearly one fifth of patients (n = 2,171, 17.4%) were ≥65 years. More women ages ≥65 years (71%) presented with late-stage disease than younger women (48% in patients ages <65). Late-stage 5-year relative survival was lower for women ≥65 years (23.2%–36.8%) compared with patients <65 (41.5%–51.5%). Characteristics associated with late-stage cervical cancer in women ≥65 years included older age [odds ratio (OR), 1.02; 95% confidence interval (CI), 1.01–1.04; each year], non-adenocarcinoma histologic subtypes, and comorbidities (OR, 1.59; 95% CI, 1.21–2.08). Conclusions: There remains a significant burden of advanced cervical cancer in women ≥65. Impact: Efforts should be made to better understand how the current screening paradigm is failing women of 65 years and older. Future work should focus on determining past screening history, lapses in follow-up care, and non-invasive testing approaches.

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Cervical stump leiomyomata after supracervical hysterectomy; a case report with review of literature

Shoukry,

Yousri

2024

Preprint

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Background Despite being highly debated issue, subtotal or supracervical hysterectomy is still considered a safe and effective treatment for women with multiple fibroid uterus. Many lesions could arise on top of the preserved cervical stump such as recurrence of fibroids, cervical polyps, endometriosis, or malignancies which may necessitate reoperation and resection of the cervical stump or trachelectomy. Trachelectomy is known to be a difficult surgical procedure that may be associated with significant intra and post-operative morbidity. Case presentation: We presented here a case with a pelvic mass related to the cervical stump presented 8 years after subtotal hysterectomy. She complained of pelvic pain and vaginal discharge and spotting. Transvaginal sonography and magnetic resonance imaging were performed and a heterogeneous pelvic mass was revealed. Surgical exploration and resection of the mass with cervical stump excision was performed. Histopathology conformed the diagnosis of cervical stump multiple leiomyomata. Conclusion Supracervical or subtotal hysterectomy could be performed in selected women with appropriate counselling, mainly in cases of multiple leiomyomata and the selected candidate should be told about the potential of recurrent fibroids in the retained cervical stump and its consequences including the need for reoperation for cervical stump resection.

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Outcomes of Women Undergoing Excision of the Retained Cervix After Supracervical Hysterectomy

Cited by 3 publications

References 18 publications

Advanced cervical stump cancer after laparoscopic subtotal hysterectomy: a case report of imaging, laparoscopic staging and treatment approach

Advanced cervical stump cancer after laparoscopic subtotal hysterectomy: a case report of imaging, laparoscopic staging and treatment approach

Cervical Cancer Stage at Diagnosis and Survival among Women ≥65 Years in California

Cervical stump leiomyomata after supracervical hysterectomy; a case report with review of literature

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