Analysis Of Conservative Surgical Treatment And Prognosis Of Microinvasive Squamous Cell Carcinoma Of The Cervix Stage Ia1 Results Of Follow-up To 20 Years

dc.creatorHartman
dc.creatorCaio Augusto; Teixeira
dc.creatorJulio Cesar; Barbosa
dc.creatorSergio Bruno; Figueiredo
dc.creatorStephanye Mariano; Lucci De Angelo Andrade
dc.creatorLiliana Aparecida; Braganca Bastos
dc.creatorJoana Froes
dc.date2017
dc.datefev
dc.date2017-11-13T13:14:02Z
dc.date2017-11-13T13:14:02Z
dc.date.accessioned2018-03-29T05:51:53Z
dc.date.available2018-03-29T05:51:53Z
dc.identifierInternational Journal Of Gynecological Cancer. Lippincott Williams & Wilkins, v. 27, p. 357 - 363, 2017.
dc.identifier1048-891X
dc.identifier1525-1438
dc.identifierWOS:000393415900025
dc.identifier10.1097/IGC.0000000000000887
dc.identifierhttp://journals.lww.com/ijgc/Abstract/2017/02000/Analysis_of_Conservative_Surgical_Treatment_and.25.aspx
dc.identifierhttp://repositorio.unicamp.br/jspui/handle/REPOSIP/327102
dc.identifier.urihttp://repositorioslatinoamericanos.uchile.cl/handle/2250/1364127
dc.descriptionThe aim of this study was to evaluate the prognosis and recurrence of microinvasive squamous cervical (MIC) cancer stage IA1 in women treated conservatively or by hysterectomy, and followed-up to 20 years. Methods: It was studied in a cohort of 139 women with MIC, 41 definitively managed by conization and 98 by hysterectomy from January 1994 to December 2003 and followed-up until 2013. The definitive treatment, age, conization technique (loop electrosurgical excision procedure or cold knife conization), cone margin, residual disease in hysterectomy specimen, and the association with recurrence (intraepithelial cervical neoplasia grade 3/intraepithelial vaginal neoplasia grade 3 or worse, and microinvasive or worse) were analyzed. Results: There were 2.5 times more conservative treatment in younger women than older (>40 years), and high proportion of residual disease in hysterectomy specimens (67% of intraepithelial cervical neoplasia grade 3 or worse), more common if positive cone margin (74% vs 35%, P < 0.002). Therewere 2.3% (3/133) recurrences detected as microinvasive or worse, and 6% (8/133) recurrences detected as intraepithelial cervical neoplasia grade 3/intraepithelial vaginal neoplasia grade 3 or worse: 7.3% (3/41) in the conization group and 5.4% (5/92) in the hysterectomy group (P = 0.701). Almost all recurrences (88%, 7/8) were diagnosed until 36 months after treatment, and they were not associated with conization technique. Therewere no differences in risk of recurrence and overall disease-free survival time related to type of treatment. Conclusions: This study demonstrates the good prognosis of MIC, regardless the treatment. When fertility is not a concern, hysterectomy should be considered as definitive treatment to avoid the risk of residual disease. Regular follow-up for a long period should be maintained.
dc.description27
dc.description2
dc.description357
dc.description363
dc.languageEnglish
dc.publisherLippincott Williams & Wilkins
dc.publisherPhiladelphia
dc.relationInternational Journal of Gynecological Cancer
dc.rightsfechado
dc.sourceWOS
dc.subjectCervical Carcinoma
dc.subjectMicroinvasive
dc.subjectStage Ia
dc.subjectTreatment
dc.subjectRecurrence
dc.titleAnalysis Of Conservative Surgical Treatment And Prognosis Of Microinvasive Squamous Cell Carcinoma Of The Cervix Stage Ia1 Results Of Follow-up To 20 Years
dc.typeArtículos de revistas


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