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Sensitivity of Follow-Up Methods in Patients After Fertility-Sparing Surgery for Cervical Cancers

SLAMA, Jiri, Daniela FISCHEROVA, Michal ZIKAN, Roman KOCIAN, Anna GERMANOVA, Filip FRUHAUF, Ladislav DUŠEK a David CIBULA. Sensitivity of Follow-Up Methods in Patients After Fertility-Sparing Surgery for Cervical Cancers. International Journal of Gynecological Cancer, Philadelphia: Lippincott Williams & Wilkins, 2017, roč. 27, č. 1, s. 147-153. ISSN 1048-891X. doi:10.1097/IGC.0000000000000835.
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Základní údaje
Originální název Sensitivity of Follow-Up Methods in Patients After Fertility-Sparing Surgery for Cervical Cancers
Autoři SLAMA, Jiri (203 Česká republika), Daniela FISCHEROVA (203 Česká republika), Michal ZIKAN (203 Česká republika), Roman KOCIAN (203 Česká republika), Anna GERMANOVA (203 Česká republika), Filip FRUHAUF (203 Česká republika), Ladislav DUŠEK (203 Česká republika, garant, domácí) a David CIBULA (203 Česká republika).
Vydání International Journal of Gynecological Cancer, Philadelphia, Lippincott Williams & Wilkins, 2017, 1048-891X.
Další údaje
Originální jazyk angličtina
Typ výsledku Článek v odborném periodiku
Obor Oncology
Stát vydavatele Spojené státy americké
Utajení není předmětem státního či obchodního tajemství
Impakt faktor Impact factor: 2.192
Kód RIV RIV/00216224:14110/17:00096203
Organizační jednotka Lékařská fakulta
Doi http://dx.doi.org/10.1097/IGC.0000000000000835
UT WoS 000391946600022
Klíčová slova anglicky Fertility-sparing surgery; Cervical cancer; Recurrence
Štítky EL OK
Příznaky Mezinárodní význam, Recenzováno
Změnil Změnila: Soňa Böhmová, učo 232884. Změněno: 20. 3. 2018 17:21.
Anotace
Objective: The aim of our study was to compare the sensitivity of various methods and their combinations in the follow-up of patients with cervical cancer after fertility-sparing surgery (FSS). Methods: Included were women with cervical cancer in stages IA2 to IB2 who underwent FSS, which includes pelvic lymphadenectomy, sentinel lymph node biopsy, abdominal radical trachelectomy, vaginal trachelectomy, or needle conization. Follow-up visits were scheduled at 3-month intervals and included symptom-oriented discussion, gynecological and physical examination, colposcopy, Papanicolaou test, human papillomavirus (HPV) DNA test, and ultrasound examination. All cases with a recurrent disease were thoroughly analyzed, and the results of individual examinations were compared. Results: In total, 43 women (IA2, 8; IB1, 33; IB2, 2) were enrolled. The mean patient age was 31 years; most patients were nulliparous (68.4%, 26/38) with squamous cell cancers (26/38). Abdominal radical trachelectomy was performed in 10 women, simple vaginal trachelectomy was performed in 11 women, and conization was performed in 22 women, according to the tumor characteristics and topography. The median duration of the follow-up reached 37 months. Invasive cancer and high- and low-grade squamous intraepithelial lesions were detected in 8, 1, and 1 patients, respectively. All except 1 event were central, detected within the first year after FSS. Only 2 cases were symptomatic. Colposcopy detected 7 of 10 recurrences; 5 of them were HPV positive, and, in 2 cases, a Papanicolaou test revealed abnormalities. Papanicolaou tests were false positive in 27.7%, especially after trachelectomies. Conclusions: Most patients in whom cancer recurred after FSS reveal central or pelvic lesions, which can be successfully treated with salvage surgery or radiotherapy. The early detection of recurrence is an essential condition for a favorable oncological outcome. Colposcopy alone and in combination with HPV positivity showed the highest sensitivity for the detection of recurrent diseases, whereas other methods had limited reliability.
VytisknoutZobrazeno: 22. 4. 2019 12:34

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