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Outcomes of Conservative Management of High Grade Squamous Intraepithelial Lesions in Young Women

OBJECTIVE: The aim of the study was to determine regression rates of cervical intraepithelial neoplasia (CIN) 2 and 3 in women younger than 24 years, followed conservatively for up to 24 months. MATERIALS AND METHODS: This is a retrospective chart review of colposcopy patients in clinic database bas...

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Autores principales: Lee, Marette H., Finlayson, Sarah J., Gukova, Ksenia, Hanley, Gillian, Miller, Dianne, Sadownik, Leslie Ann
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6023603/
https://www.ncbi.nlm.nih.gov/pubmed/29762428
http://dx.doi.org/10.1097/LGT.0000000000000399
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author Lee, Marette H.
Finlayson, Sarah J.
Gukova, Ksenia
Hanley, Gillian
Miller, Dianne
Sadownik, Leslie Ann
author_facet Lee, Marette H.
Finlayson, Sarah J.
Gukova, Ksenia
Hanley, Gillian
Miller, Dianne
Sadownik, Leslie Ann
author_sort Lee, Marette H.
collection PubMed
description OBJECTIVE: The aim of the study was to determine regression rates of cervical intraepithelial neoplasia (CIN) 2 and 3 in women younger than 24 years, followed conservatively for up to 24 months. MATERIALS AND METHODS: This is a retrospective chart review of colposcopy patients in clinic database based on the following: (1) younger than 24 years at first visit; (2) first visit January 1, 2010, to May 31, 2013, and at least 1 follow-up visit after diagnosis; (3) histologic diagnosis of CIN2+; and (4) optimal conservative management (observation for up to 24 months or to 24 years, whichever occurred first). Patient information and clinical/pathologic data were extracted from charts to examine patient characteristics and treatment outcomes, CIN2+ regression rates, median times to regression for CIN2 versus CIN3 (Kaplan-Meier survival analysis), and predictors of regression (multivariate logistic regression analysis). RESULTS: A total of 154 women met criteria. The most severe histological diagnoses were CIN2 in 99 (64.3%), CIN3 in 51 (33.1%), and adenocarcinoma in situ in 4 (2.6%). Adenocarcinoma in situ was immediately treated. In follow-up, CIN2 regressed to CIN1 or negative in 74 women (74.7%)-median time to regression, 10.8 months. Cervical intraepithelial neoplasia 3 regressed in 11 women (21.6%)-median time to regression not reached (last follow-up censored at 52.7 months). Cervical intraepithelial neoplasia 2 on biopsy, low grade referral Pap, and younger age predicted regression. Overall, 49 women (31.8%) were treated. CONCLUSIONS: Conservative management should continue to be recommended to young women with CIN2. Rigorous retention mechanisms are required to ensure that these women return for follow-up.
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spelling pubmed-60236032018-07-11 Outcomes of Conservative Management of High Grade Squamous Intraepithelial Lesions in Young Women Lee, Marette H. Finlayson, Sarah J. Gukova, Ksenia Hanley, Gillian Miller, Dianne Sadownik, Leslie Ann J Low Genit Tract Dis Original Research Articles: Cervix and HPV OBJECTIVE: The aim of the study was to determine regression rates of cervical intraepithelial neoplasia (CIN) 2 and 3 in women younger than 24 years, followed conservatively for up to 24 months. MATERIALS AND METHODS: This is a retrospective chart review of colposcopy patients in clinic database based on the following: (1) younger than 24 years at first visit; (2) first visit January 1, 2010, to May 31, 2013, and at least 1 follow-up visit after diagnosis; (3) histologic diagnosis of CIN2+; and (4) optimal conservative management (observation for up to 24 months or to 24 years, whichever occurred first). Patient information and clinical/pathologic data were extracted from charts to examine patient characteristics and treatment outcomes, CIN2+ regression rates, median times to regression for CIN2 versus CIN3 (Kaplan-Meier survival analysis), and predictors of regression (multivariate logistic regression analysis). RESULTS: A total of 154 women met criteria. The most severe histological diagnoses were CIN2 in 99 (64.3%), CIN3 in 51 (33.1%), and adenocarcinoma in situ in 4 (2.6%). Adenocarcinoma in situ was immediately treated. In follow-up, CIN2 regressed to CIN1 or negative in 74 women (74.7%)-median time to regression, 10.8 months. Cervical intraepithelial neoplasia 3 regressed in 11 women (21.6%)-median time to regression not reached (last follow-up censored at 52.7 months). Cervical intraepithelial neoplasia 2 on biopsy, low grade referral Pap, and younger age predicted regression. Overall, 49 women (31.8%) were treated. CONCLUSIONS: Conservative management should continue to be recommended to young women with CIN2. Rigorous retention mechanisms are required to ensure that these women return for follow-up. Lippincott Williams & Wilkins 2018-07 2018-03-22 /pmc/articles/PMC6023603/ /pubmed/29762428 http://dx.doi.org/10.1097/LGT.0000000000000399 Text en Copyright © 2018 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the ASCCP. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND) (http://creativecommons.org/licenses/by-nc-nd/4.0/) , where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.
spellingShingle Original Research Articles: Cervix and HPV
Lee, Marette H.
Finlayson, Sarah J.
Gukova, Ksenia
Hanley, Gillian
Miller, Dianne
Sadownik, Leslie Ann
Outcomes of Conservative Management of High Grade Squamous Intraepithelial Lesions in Young Women
title Outcomes of Conservative Management of High Grade Squamous Intraepithelial Lesions in Young Women
title_full Outcomes of Conservative Management of High Grade Squamous Intraepithelial Lesions in Young Women
title_fullStr Outcomes of Conservative Management of High Grade Squamous Intraepithelial Lesions in Young Women
title_full_unstemmed Outcomes of Conservative Management of High Grade Squamous Intraepithelial Lesions in Young Women
title_short Outcomes of Conservative Management of High Grade Squamous Intraepithelial Lesions in Young Women
title_sort outcomes of conservative management of high grade squamous intraepithelial lesions in young women
topic Original Research Articles: Cervix and HPV
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6023603/
https://www.ncbi.nlm.nih.gov/pubmed/29762428
http://dx.doi.org/10.1097/LGT.0000000000000399
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