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@article{1373487,
author = {Slama, Jiri and Fischerova, Daniela and Zikan, Michal and Kocian, Roman and Germanova, Anna and Fruhauf, Filip and Dušek, Ladislav and Cibula, David},
article_location = {Philadelphia},
article_number = {1},
doi = {http://dx.doi.org/10.1097/IGC.0000000000000835},
keywords = {Fertility-sparing surgery; Cervical cancer; Recurrence},
language = {eng},
issn = {1048-891X},
journal = {International Journal of Gynecological Cancer},
title = {Sensitivity of Follow-Up Methods in Patients After Fertility-Sparing Surgery for Cervical Cancers},
volume = {27},
year = {2017}
}
TY - JOUR
ID - 1373487
AU - Slama, Jiri - Fischerova, Daniela - Zikan, Michal - Kocian, Roman - Germanova, Anna - Fruhauf, Filip - Dušek, Ladislav - Cibula, David
PY - 2017
TI - Sensitivity of Follow-Up Methods in Patients After Fertility-Sparing Surgery for Cervical Cancers
JF - International Journal of Gynecological Cancer
VL - 27
IS - 1
SP - 147-153
EP - 147-153
PB - Lippincott Williams & Wilkins
SN - 1048891X
KW - Fertility-sparing surgery
KW - Cervical cancer
KW - Recurrence
N2 - 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.
ER -
SLAMA, Jiri, Daniela FISCHEROVA, Michal ZIKAN, Roman KOCIAN, Anna GERMANOVA, Filip FRUHAUF, Ladislav DUŠEK and David CIBULA. Sensitivity of Follow-Up Methods in Patients After Fertility-Sparing Surgery for Cervical Cancers. \textit{International Journal of Gynecological Cancer}. Philadelphia: Lippincott Williams \&{} Wilkins, 2017, vol.~27, No~1, p.~147-153. ISSN~1048-891X. Available from: https://dx.doi.org/10.1097/IGC.0000000000000835.
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