Cargando…
Analysis of pathological and clinical characteristics of cervical conization according to age group in Japan
OBJECTIVE: With increased screening, more patients with precancerous or early cervical cancer are now being identified. Age at pregnancy, and thus number of patients requiring fertility preservation, have also increased, resulting in more diagnostic and therapeutic cervical conization (conization) p...
Autores principales: | , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier
2020
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7560578/ https://www.ncbi.nlm.nih.gov/pubmed/33088958 http://dx.doi.org/10.1016/j.heliyon.2020.e05193 |
_version_ | 1783595115503157248 |
---|---|
author | Murakami, Isao Ohno, Akiko Ikeda, Masae Yamashita, Hiroshi Mikami, Mikio Kobayashi, Yoichi Nagase, Satoru Yokoyama, Masatoshi Enomoto, Takayuki Katabuchi, Hidetaka |
author_facet | Murakami, Isao Ohno, Akiko Ikeda, Masae Yamashita, Hiroshi Mikami, Mikio Kobayashi, Yoichi Nagase, Satoru Yokoyama, Masatoshi Enomoto, Takayuki Katabuchi, Hidetaka |
author_sort | Murakami, Isao |
collection | PubMed |
description | OBJECTIVE: With increased screening, more patients with precancerous or early cervical cancer are now being identified. Age at pregnancy, and thus number of patients requiring fertility preservation, have also increased, resulting in more diagnostic and therapeutic cervical conization (conization) procedures. We here investigated the pathological and clinical characteristics of patients undergoing conization, with a focus on age. The objectives of our study were to identify the risk factors potentially involved in cervical intraepithelial neoplasia (CIN) recurrence or persistence, additional treatment after conization, the effects of conization on pregnancy, and the actual status of conization in Japan. STUDY DESIGN: A “Subcommittee for Investigation of Cervical Conization” within the Gynecologic Oncology Committee in the Japan Society of Obstetrics and Gynecology investigated pathological and clinical characteristics of conization at 205 institutions in Japan. We analyzed pathological and clinical characteristics according to age ≤50 and >50 years. RESULTS: Patients aged 20–40 years accounted for 12904 (87%) of the 14,832 study patients (median: 37 years, range: 16–88 years). However, 1838 (12.4%) were aged >50 years. The commonest post-operative diagnosis was CIN grade 3 in all age groups. Rates of invasive cancer, post-operative detection of more advanced lesions, positive surgical margins, additional treatment, and recurrence were significantly higher in patients aged ≥50 years than those aged <50 years (all p < 0.01), whereas rates of post-operative complications did not differ significantly between age groups. The relationship between cerclage and the incidence of amniorrhexis or premature birth did not differ significantly in any age group. CONCLUSION: Post-conization management of patients aged ≥50 years requires considering the high rates of detection of more advanced lesions post-operatively, positive surgical margins, and recurrence. Cerclage should not be performed post-conization without careful consideration. |
format | Online Article Text |
id | pubmed-7560578 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Elsevier |
record_format | MEDLINE/PubMed |
spelling | pubmed-75605782020-10-20 Analysis of pathological and clinical characteristics of cervical conization according to age group in Japan Murakami, Isao Ohno, Akiko Ikeda, Masae Yamashita, Hiroshi Mikami, Mikio Kobayashi, Yoichi Nagase, Satoru Yokoyama, Masatoshi Enomoto, Takayuki Katabuchi, Hidetaka Heliyon Research Article OBJECTIVE: With increased screening, more patients with precancerous or early cervical cancer are now being identified. Age at pregnancy, and thus number of patients requiring fertility preservation, have also increased, resulting in more diagnostic and therapeutic cervical conization (conization) procedures. We here investigated the pathological and clinical characteristics of patients undergoing conization, with a focus on age. The objectives of our study were to identify the risk factors potentially involved in cervical intraepithelial neoplasia (CIN) recurrence or persistence, additional treatment after conization, the effects of conization on pregnancy, and the actual status of conization in Japan. STUDY DESIGN: A “Subcommittee for Investigation of Cervical Conization” within the Gynecologic Oncology Committee in the Japan Society of Obstetrics and Gynecology investigated pathological and clinical characteristics of conization at 205 institutions in Japan. We analyzed pathological and clinical characteristics according to age ≤50 and >50 years. RESULTS: Patients aged 20–40 years accounted for 12904 (87%) of the 14,832 study patients (median: 37 years, range: 16–88 years). However, 1838 (12.4%) were aged >50 years. The commonest post-operative diagnosis was CIN grade 3 in all age groups. Rates of invasive cancer, post-operative detection of more advanced lesions, positive surgical margins, additional treatment, and recurrence were significantly higher in patients aged ≥50 years than those aged <50 years (all p < 0.01), whereas rates of post-operative complications did not differ significantly between age groups. The relationship between cerclage and the incidence of amniorrhexis or premature birth did not differ significantly in any age group. CONCLUSION: Post-conization management of patients aged ≥50 years requires considering the high rates of detection of more advanced lesions post-operatively, positive surgical margins, and recurrence. Cerclage should not be performed post-conization without careful consideration. Elsevier 2020-10-08 /pmc/articles/PMC7560578/ /pubmed/33088958 http://dx.doi.org/10.1016/j.heliyon.2020.e05193 Text en © 2020 The Authors. Published by Elsevier Ltd. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). |
spellingShingle | Research Article Murakami, Isao Ohno, Akiko Ikeda, Masae Yamashita, Hiroshi Mikami, Mikio Kobayashi, Yoichi Nagase, Satoru Yokoyama, Masatoshi Enomoto, Takayuki Katabuchi, Hidetaka Analysis of pathological and clinical characteristics of cervical conization according to age group in Japan |
title | Analysis of pathological and clinical characteristics of cervical conization according to age group in Japan |
title_full | Analysis of pathological and clinical characteristics of cervical conization according to age group in Japan |
title_fullStr | Analysis of pathological and clinical characteristics of cervical conization according to age group in Japan |
title_full_unstemmed | Analysis of pathological and clinical characteristics of cervical conization according to age group in Japan |
title_short | Analysis of pathological and clinical characteristics of cervical conization according to age group in Japan |
title_sort | analysis of pathological and clinical characteristics of cervical conization according to age group in japan |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7560578/ https://www.ncbi.nlm.nih.gov/pubmed/33088958 http://dx.doi.org/10.1016/j.heliyon.2020.e05193 |
work_keys_str_mv | AT murakamiisao analysisofpathologicalandclinicalcharacteristicsofcervicalconizationaccordingtoagegroupinjapan AT ohnoakiko analysisofpathologicalandclinicalcharacteristicsofcervicalconizationaccordingtoagegroupinjapan AT ikedamasae analysisofpathologicalandclinicalcharacteristicsofcervicalconizationaccordingtoagegroupinjapan AT yamashitahiroshi analysisofpathologicalandclinicalcharacteristicsofcervicalconizationaccordingtoagegroupinjapan AT mikamimikio analysisofpathologicalandclinicalcharacteristicsofcervicalconizationaccordingtoagegroupinjapan AT kobayashiyoichi analysisofpathologicalandclinicalcharacteristicsofcervicalconizationaccordingtoagegroupinjapan AT nagasesatoru analysisofpathologicalandclinicalcharacteristicsofcervicalconizationaccordingtoagegroupinjapan AT yokoyamamasatoshi analysisofpathologicalandclinicalcharacteristicsofcervicalconizationaccordingtoagegroupinjapan AT enomototakayuki analysisofpathologicalandclinicalcharacteristicsofcervicalconizationaccordingtoagegroupinjapan AT katabuchihidetaka analysisofpathologicalandclinicalcharacteristicsofcervicalconizationaccordingtoagegroupinjapan |