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Conference Paper: Positive Surgical Margin At Cervical Conization For High-grade Squamous Intraepithelial Lesion: Does It Matter?

TitlePositive Surgical Margin At Cervical Conization For High-grade Squamous Intraepithelial Lesion: Does It Matter?
Authors
Issue Date2018
PublisherLippincott Williams & Wilkins. The Journal's web site is located at http://www.ijgc.net/
Citation
17th Biennial Meeting of the International Gynecologic Cancer Society, Kyoto, Japan, 14-16 September 2018. In International Journal of Gynecological Cancer, 2018, v. 28 n. Suppl. 2, p. 551 How to Cite?
AbstractBackground and Aims: Our study aimed to assess the significance of positive margin in the outcome of women following conization for high-grade squamous intraepithelial lesion (HSIL). Methods: All women evaluated for abnormal cervical smear at a single institution were prospectively entered into a database. The database was queried for all women who had a conization performed for HSIL between 1st January 2013 and 31st December 2015. Factors retrieved from the database included demographics and pathology results. Chi-square test was used with significance defined at p<0.05. Results: 291 women were identified, of which 119 (40.9%) had positive margin. The median age was 38 years. Loop electrosurgical excision procedure was performed in 286 women and cold knife cone in 5 women. Median follow-up was 30 months with 27 (9.3%) women lost to follow-up. Overall, the risk of persistence/recurrence was 6.8%. Positive margin and glandular involvement were associated with statistically higher risk of persistence/recurrence compared with negative margin or absent of glandular involvement (14.3% vs 0.6%, p=0.0001; 9.0% vs 0%, p=0.0277 respectively). Risk of persistence/recurrence increases with more quadrants (Q) being involved by squamous intraepithelial lesion (1Q=4.3%; 2Q=4.8%; 3Q=6.3%; 4Q=11.5%). Positive margin was associated with statistically higher risk of subsequent abnormal smear (40.3% vs 23.8%, p=0.0046), requiring further colposcopy (23.5% vs 8.1%, p=0.0006) and conization (11.8% vs 2.5%, p=0.0041) compared with negative margin. Ten women had hysterectomy (1 for microinvasion, 4 had coexisting adenocarcinoma in-situ, 4 for persistence/recurrence of HSIL of which 1 had invasive squamous cell carcinoma and 1 for symptomatic fibroid). Two women developed vaginal HSIL. Conclusions: In our population, most women (85.7%) with positive margin did not have persistence/recurrence of HSIL, of which the option of close follow-up with cytology may be reasonable. Repeat conization may be considered in selected women with positive margin, glandular involvement and extensive HSIL and those who are unable to comply with follow-up.
DescriptionPPE25 Poster Presentation: Gynecologic Pathology/Cytology and Disease Pathogenesis - Abstract: 449
Persistent Identifierhttp://hdl.handle.net/10722/262450
ISSN
2019 Impact Factor: 2.095
2015 SCImago Journal Rankings: 0.830

 

DC FieldValueLanguage
dc.contributor.authorNgu, SF-
dc.contributor.authorChan, KKL-
dc.contributor.authorTse, KY-
dc.contributor.authorChu, MYM-
dc.contributor.authorIp, PCP-
dc.contributor.authorCheung, ANY-
dc.contributor.authorNgan, HYS-
dc.date.accessioned2018-09-28T04:59:31Z-
dc.date.available2018-09-28T04:59:31Z-
dc.date.issued2018-
dc.identifier.citation17th Biennial Meeting of the International Gynecologic Cancer Society, Kyoto, Japan, 14-16 September 2018. In International Journal of Gynecological Cancer, 2018, v. 28 n. Suppl. 2, p. 551-
dc.identifier.issn1048-891X-
dc.identifier.urihttp://hdl.handle.net/10722/262450-
dc.descriptionPPE25 Poster Presentation: Gynecologic Pathology/Cytology and Disease Pathogenesis - Abstract: 449-
dc.description.abstractBackground and Aims: Our study aimed to assess the significance of positive margin in the outcome of women following conization for high-grade squamous intraepithelial lesion (HSIL). Methods: All women evaluated for abnormal cervical smear at a single institution were prospectively entered into a database. The database was queried for all women who had a conization performed for HSIL between 1st January 2013 and 31st December 2015. Factors retrieved from the database included demographics and pathology results. Chi-square test was used with significance defined at p<0.05. Results: 291 women were identified, of which 119 (40.9%) had positive margin. The median age was 38 years. Loop electrosurgical excision procedure was performed in 286 women and cold knife cone in 5 women. Median follow-up was 30 months with 27 (9.3%) women lost to follow-up. Overall, the risk of persistence/recurrence was 6.8%. Positive margin and glandular involvement were associated with statistically higher risk of persistence/recurrence compared with negative margin or absent of glandular involvement (14.3% vs 0.6%, p=0.0001; 9.0% vs 0%, p=0.0277 respectively). Risk of persistence/recurrence increases with more quadrants (Q) being involved by squamous intraepithelial lesion (1Q=4.3%; 2Q=4.8%; 3Q=6.3%; 4Q=11.5%). Positive margin was associated with statistically higher risk of subsequent abnormal smear (40.3% vs 23.8%, p=0.0046), requiring further colposcopy (23.5% vs 8.1%, p=0.0006) and conization (11.8% vs 2.5%, p=0.0041) compared with negative margin. Ten women had hysterectomy (1 for microinvasion, 4 had coexisting adenocarcinoma in-situ, 4 for persistence/recurrence of HSIL of which 1 had invasive squamous cell carcinoma and 1 for symptomatic fibroid). Two women developed vaginal HSIL. Conclusions: In our population, most women (85.7%) with positive margin did not have persistence/recurrence of HSIL, of which the option of close follow-up with cytology may be reasonable. Repeat conization may be considered in selected women with positive margin, glandular involvement and extensive HSIL and those who are unable to comply with follow-up.-
dc.languageeng-
dc.publisherLippincott Williams & Wilkins. The Journal's web site is located at http://www.ijgc.net/-
dc.relation.ispartofInternational Journal of Gynecological Cancer-
dc.relation.ispartof17th Biennial Meeting of the International Gynecologic Cancer Society, 2018-
dc.rightsCopyright © 2018 by IGCS and ESGO-
dc.titlePositive Surgical Margin At Cervical Conization For High-grade Squamous Intraepithelial Lesion: Does It Matter?-
dc.typeConference_Paper-
dc.identifier.emailNgu, SF: ngusiewf@hku.hk-
dc.identifier.emailChan, KKL: kklchan@hkucc.hku.hk-
dc.identifier.emailTse, KY: tseky@hku.hk-
dc.identifier.emailChu, MYM: chumy@hku.hk-
dc.identifier.emailIp, PCP: philipip@hku.hk-
dc.identifier.emailCheung, ANY: anycheun@hkucc.hku.hk-
dc.identifier.emailNgan, HYS: hysngan@hkucc.hku.hk-
dc.identifier.authorityNgu, SF=rp01367-
dc.identifier.authorityChan, KKL=rp00499-
dc.identifier.authorityTse, KY=rp02391-
dc.identifier.authorityIp, PCP=rp01890-
dc.identifier.authorityCheung, ANY=rp00542-
dc.identifier.authorityNgan, HYS=rp00346-
dc.identifier.hkuros292289-
dc.identifier.volume28-
dc.identifier.issueSuppl. 2-
dc.identifier.spage551-
dc.identifier.epage551-
dc.publisher.placeUnited States-

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