宫颈原位腺癌治疗选择对残留率、复发率和进展的影响

IF 0.1 Q4 OBSTETRICS & GYNECOLOGY
J. Theuws, D. Allen
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引用次数: 0

摘要

摘要背景:原位宫颈腺癌(AIS)是已知的宫颈腺癌的先兆疾病。本研究的目的是评估AIS在残余疾病、复发和进展为侵袭性癌症方面的治疗选择。方法:这是一项在澳大利亚墨尔本梅西妇女医院进行的回顾性队列研究。纳入了2000年至2013年间在组织学上被诊断为AIS的女性。对患者记录进行审查,以了解症状、细胞学、阴道镜检查和活检报告、初始治疗、任何后续治疗、结果和随访。结果:共纳入114名患者:87名患者接受了一次或多次保留生育能力的手术;25名患者随后接受了子宫切除术、一次气管切开术和一次化疗和放疗。31%(9/29)的患者在之前的手术后发现残余疾病,边缘呈阳性。在13.3%(2/15)的患者中,尽管手术边缘清晰,但仍诊断出残余疾病。平均随访时间为78.6个月(7.9-183)。两名主要接受保留生育能力治疗的患者(2/87,2.3%)复发性AIS。所有患者均未进展为侵袭性癌症。结论:在每个病例中,必须仔细考虑初次治疗后的阳性和阴性边缘。在负边际的情况下,保留生育能力的手术应该是所有女性的治疗选择,而不仅仅是那些想要保持生育能力的女性。保留生育能力的手术需要定期随访。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Effect of treatment choices for cervical adenocarcinoma in situ on rates of residual disease, recurrence and progression
Abstract Background: Cervical adenocarcinoma in situ (AIS) is the known precursor condition of cervical adenocarcinoma. The aim of this study is to evaluate treatment choices for AIS in terms of residual disease, recurrence and progression to invasive cancer. Methods: This is a retrospective cohort study conducted at the Mercy Hospital for Women in Melbourne, Australia. Women diagnosed with AIS on histology between 2000 and 2013 were included. Patient records were reviewed for notes on symptoms, cytology, colposcopy and biopsy reports, initial treatment, any subsequent treatment, outcome and follow-up. Results: A total of 114 patients were included: 87 patients were treated with one or more fertility-sparing procedures; 25 patients received a subsequent hysterectomy, one a trachelectomy and one chemo- and radiotherapy. Residual disease was found in 31% (9/29) after a previous procedure with positive margins. In 13.3% (2/15) residual disease was diagnosed despite clear surgical margins. The mean follow-up time was 78.6 months (range 7.9–183). Two patients (2/87, 2.3%) who primarily received fertility-sparing treatment had recurrent AIS. None of the patients progressed to invasive cancer. Conclusion: Both positive and negative margins after initial treatment must be carefully considered in each case. With negative margins, fertility-sparing surgery should be a treatment choice available for all women, not only for those who want to preserve fertility. Fertility-sparing surgery requires regular follow-up.
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