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Treatment failure following excision therapy of CIN: the impact of direct colposcopic vision during procedure.
Heineman, Mellie; Mancini, Julien; Villeret, Julia; Agostini, Aubert; Houvenaeghel, Gilles; Boubli, Léon; Carcopino, Xavier.
Afiliação
  • Heineman M; Department of Obstetrics and Gynaecology, Hôpital Nord, Assistance Publique des Hôpitaux de Marseille (APHM), Aix-Marseille Université (AMU), Chemin des Bourrely, 13015, Marseille, France.
  • Mancini J; Aix-Marseille Université, Inserm, IRD, UMR S912, SESSTIM, 13385, Marseille, France.
  • Villeret J; Public Health Department, APHM, Hôpital de la Timone, BioSTIC, 13385, Marseille, France.
  • Agostini A; Department of Pathology, Assistance Publique des Hôpitaux de Marseille (APHM), Hôpital Nord, Marseille, France.
  • Houvenaeghel G; Aix-Marseille Université, Inserm, IRD, UMR S912, SESSTIM, 13385, Marseille, France.
  • Boubli L; Department of Obstetrics and Gynaecology, Hôpital La Conception, Assistance Publique des Hôpitaux de Marseille, Aix-Marseille Université (AMU), Marseille, France.
  • Carcopino X; Aix-Marseille Université, Inserm, IRD, UMR S912, SESSTIM, 13385, Marseille, France.
Arch Gynecol Obstet ; 293(4): 825-31, 2016 Apr.
Article em En | MEDLINE | ID: mdl-26404447
PURPOSE: To assess whether the use of direct colposcopic vision during excision therapy of cervical intraepithelial neoplasia (CIN) has an impact on the risk of treatment failure. METHODS: Data from 285 patients who had had excision therapy with proven CIN at specimen histological analysis were reviewed. Primary endpoint was the occurrence of post-treatment failure defined by the histological diagnosis of CIN 2-3 during follow-up. Data were analysed according to the use of colposcopy at the time of initial therapy of CIN. RESULTS: The use of direct colposcopic vision (DCV) resulted in a significant reduction in the mean height (p = 0.008) and diameter (p < 0.001) of the excised specimen. Patients' median follow-up was 28.4 (±1.3) months. A total of 43 (15.2 %) patients were diagnosed with treatment failure. Compared to excisions performed without any use of colposcopy, DCV was not found to have any significant impact on the risk of treatment failure (HR: 0.58; 95 % CI 0.16-2.13, p = 0.412), neither when compared to excisions performed immediately after colposcopy (HR: 0.91; 95 % CI 0.47-1.79; p = 0.794). The only factors found to have a significant impact on the risk of treatment failure was the identification of clear margins (HR: 0.36; 95 %CI 0.19-0.69; p = 0.002) and the diameter of the surgical specimen (HR: 0.94; 95 %CI 0.89-0.99; p = 0.040). CONCLUSIONS: Although the use of DCV during excision therapy of CIN was associated with a significant reduction in the dimensions of the excised cervical specimen, it did not result in a significant change in the risk of treatment failure.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Displasia do Colo do Útero / Neoplasias do Colo do Útero / Colposcopia Tipo de estudo: Etiology_studies / Prognostic_studies / Risk_factors_studies Limite: Adult / Female / Humans / Middle aged / Pregnancy Idioma: En Ano de publicação: 2016 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Displasia do Colo do Útero / Neoplasias do Colo do Útero / Colposcopia Tipo de estudo: Etiology_studies / Prognostic_studies / Risk_factors_studies Limite: Adult / Female / Humans / Middle aged / Pregnancy Idioma: En Ano de publicação: 2016 Tipo de documento: Article