Seguimiento de las lesiones escamosas intraepiteliales de alto grado (H-SIL) tras conización con asa diatérmica / Follow-up of high risk intraepithelial lesions after loop excision

Objetivo: Establecer el porcentaje de persistencias de las lesiones escamosas intraepiteliales de alto grado (H-SIL) tras realizar la conización con asa diatérmica, así como el momento del diagnóstico tras la intervención. Material y método: Revisión de los casos de conización por H-SIL en un período de 5 años en nuestra unidad de patología cervical. Analizamos el informe anatomopatológico de la pieza, las persistencias de H-SIL, la presencia de carcinomas y el número de curaciones, así como las pérdidas de seguimiento y la correlación de los márgenes afectados con la persistencia de H-SIL y con la presencia de carcinoma. Resultados: Nuestro porcentaje de curaciones es similar a las cifras publicadas. Hay diferencia significativa entre la existencia de carcinomas en las piezas de H-SIL cuando ambos márgenes están afectados y cuando los márgenes están libres. El momento de detección de la persistencia o recidiva de la lesión siempre fue en el primer control, excepto en un caso. Conclusiones: El seguimiento de las pacientes con conización por H-SIL es importante para detectar la persistencia de H-SIL

Objective: To evaluate whether the surveillance schedule for patients treated with loop excision for high-grade squamous intraepithelial lesions (H-SIL) could be improved. Material and method: We reviewed patients followed-up after loop excision of H-SIL in our unit over a 5-year period. We analyzed histologic confirmation of lesion, risk of recurrence of high-grade dysplasia, the presence of carcinomas, the number of patients with complete resolution, losses to follow-up, and the correlation between margin status and H-SIL recurrence and the presence of carcinoma. Results: The cure rate in this study was similar to rates reported in the literature. A significant difference was found between the presence of carcinoma in H-SIL surgical specimens when both margins were involved compared with disease-free margins. In all but one patient, recurrence was detected in the first follow-up examination. Conclusions: An optimal surveillance schedule for women treated for high-grade dysplasia with loop excision is important to detect and treat recurrent disease

Concurrent chemotherapy and radiotherapy for cervical cancer.

OBJECTIVE: To compare the results obtained following treatment, from a group of patients with locally advanced cervical cancer (Stage IB or higher) treated with concurrent chemotherapy and radiotherapy in relation to a group of patients treated exclusively with radiotherapy. MATERIAL AND METHOD: All patients treated with concurrent chemotherapy and radiotherapy at the Gynaecologic Oncology Unit of the University Hospital Materno Infantil of the Canaries between 1999 and 2000, both inclusive, were included. The first group to be considered was formed by patients who received combined treatment. The second group of patients received radiotherapy exclusively, having been treated in previous years (1997-1998 period). The results were compared in relation to survival in the two following years from treatment (2000-2001) in the group of combined treatment and years 1999-2000 in the group that received only radiotherapy. To compare the survival of both groups the chi-square test and Odds Ratio were utilised. RESULTS: The groups compared are homogeneous when looking at the stage of the disease when diagnosed, the histological type of tumour and its degree of cellular differentiation, the CAT results and tumoral markers. Survival of more than two years was observed in the group treated with concurrent chemotherapy and radiotherapy in relation to the group treated exclusively with radiotherapy; chi-square 9.92, p < 0.01, OR: 0.1 (0.01-0.6).