Analysis of pathological and clinical characteristics of cervical conization according to age group in Japan.
Age
Cancer research
Cancer surgery
Cerclage
Cervical conization
Cervical intraepithelial neoplasia
Clinical research
Gynecology
Oncology
Pregnancy
Prognosis
Journal
Heliyon
ISSN: 2405-8440
Titre abrégé: Heliyon
Pays: England
ID NLM: 101672560
Informations de publication
Date de publication:
Oct 2020
Oct 2020
Historique:
received:
03
06
2020
revised:
29
06
2020
accepted:
05
10
2020
entrez:
22
10
2020
pubmed:
23
10
2020
medline:
23
10
2020
Statut:
epublish
Résumé
With increased screening, more patients with precancerous or early cervical cancer are now being identified. Age at pregnancy, and thus number of patients requiring fertility preservation, have also increased, resulting in more diagnostic and therapeutic cervical conization (conization) procedures. We here investigated the pathological and clinical characteristics of patients undergoing conization, with a focus on age. The objectives of our study were to identify the risk factors potentially involved in cervical intraepithelial neoplasia (CIN) recurrence or persistence, additional treatment after conization, the effects of conization on pregnancy, and the actual status of conization in Japan. A "Subcommittee for Investigation of Cervical Conization" within the Gynecologic Oncology Committee in the Japan Society of Obstetrics and Gynecology investigated pathological and clinical characteristics of conization at 205 institutions in Japan. We analyzed pathological and clinical characteristics according to age ≤50 and >50 years. Patients aged 20-40 years accounted for 12904 (87%) of the 14,832 study patients (median: 37 years, range: 16-88 years). However, 1838 (12.4%) were aged >50 years. The commonest post-operative diagnosis was CIN grade 3 in all age groups. Rates of invasive cancer, post-operative detection of more advanced lesions, positive surgical margins, additional treatment, and recurrence were significantly higher in patients aged ≥50 years than those aged <50 years (all p < 0.01), whereas rates of post-operative complications did not differ significantly between age groups. The relationship between cerclage and the incidence of amniorrhexis or premature birth did not differ significantly in any age group. Post-conization management of patients aged ≥50 years requires considering the high rates of detection of more advanced lesions post-operatively, positive surgical margins, and recurrence. Cerclage should not be performed post-conization without careful consideration.
Identifiants
pubmed: 33088958
doi: 10.1016/j.heliyon.2020.e05193
pii: S2405-8440(20)32036-3
pmc: PMC7560578
doi:
Types de publication
Journal Article
Langues
eng
Pagination
e05193Informations de copyright
© 2020 The Authors. Published by Elsevier Ltd.
Références
Am J Obstet Gynecol. 2007 Oct;197(4):340-5
pubmed: 17904956
Obstet Gynecol. 2009 Oct;114(4):727-35
pubmed: 19888028
Climacteric. 2015;18(4):617-23
pubmed: 25603323
BMJ. 2008 Sep 18;337:a1284
pubmed: 18801868
Obstet Gynecol. 1998 Jun;91(6):973-6
pubmed: 9611007
Gynecol Oncol. 2005 Mar;96(3):771-5
pubmed: 15721425
BJOG. 2011 Aug;118(9):1031-41
pubmed: 21449928
J Gynecol Obstet Biol Reprod (Paris). 1997;26(1):64-70
pubmed: 9091546
BMJ. 2014 Oct 28;349:g6192
pubmed: 25352501
Acta Obstet Gynecol Scand. 2007;86(4):423-8
pubmed: 17486463
Int J Clin Oncol. 2015 Apr;20(2):240-8
pubmed: 25800808
Lancet Oncol. 2017 Dec;18(12):1665-1679
pubmed: 29126708
Int J Gynecol Pathol. 1993 Apr;12(2):186-92
pubmed: 8463044
Lancet Oncol. 2007 Nov;8(11):985-93
pubmed: 17928267
J Oncol. 2019 Nov 6;2019:7137891
pubmed: 31781217
BMJ. 2008 Sep 18;337:a1343
pubmed: 18801869
JAMA. 2007 Feb 28;297(8):813-9
pubmed: 17327523
Obstet Gynecol. 2007 Feb;109(2 Pt 1):309-13
pubmed: 17267829
Gynecol Oncol. 2019 Aug;154(2):354-359
pubmed: 31176553
Int J Gynecol Cancer. 2008 Jan-Feb;18(1):90-4
pubmed: 17506849
Anticancer Res. 2008 Nov-Dec;28(6B):3941-4
pubmed: 19192654
Int J Gynaecol Obstet. 2017 Apr;137(1):72-77
pubmed: 28129439
Obstet Gynecol. 2009 Sep;114(3):504-10
pubmed: 19701027
BMC Pregnancy Childbirth. 2018 Jul 3;18(1):277
pubmed: 29970019
Eur J Gynaecol Oncol. 2016;37(3):327-31
pubmed: 27352558
Arch Gynecol Obstet. 2010 Jul;282(1):69-73
pubmed: 19940997
Obstet Gynecol. 2011 Mar;117(3):663-71
pubmed: 21446209
Eur J Obstet Gynecol Reprod Biol. 2003 Feb 10;106(2):214-8
pubmed: 12551795
BMJ. 2016 Jul 28;354:i3633
pubmed: 27469988
Lancet. 2006 Feb 11;367(9509):489-98
pubmed: 16473126
J Gynecol Oncol. 2017 Mar;28(2):e32
pubmed: 28198168
Acta Obstet Gynecol Scand. 2007;86(5):596-603
pubmed: 17464590
Int J Gynaecol Obstet. 2009 Nov;107(2):107-10
pubmed: 19628208
BJOG. 2007 Jan;114(1):70-80
pubmed: 17083653
Gynecol Oncol. 2006 Nov;103(2):604-7
pubmed: 16750257
Am J Obstet Gynecol. 2009 Jul;201(1):33.e1-6
pubmed: 19345930
Exp Ther Med. 2013 Jan;5(1):185-188
pubmed: 23251264