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Risk Factors of Post-Large Loop Excision of the Transformation Zone Recurrent High-Grade Cervical Intraepithelial Lesion: A Prospective Cohort Study.
Demarquet, Emilie; Mancini, Julien; Preaubert, Lise; Gondry, Jean; Chevreau, Julien; Lamblin, Gery; Lebail, Karine; Lavoué, Vincent; Pinsard, Marion; Baldauf, Jean-Jacques; Bryand, Angélique; Henno, Sebastien; Agostini, Aubert; Douvier, Serge; Jarniat, Adelaïde; Riethmuller, Didier; Mendel, Anne; Brun, Jean-Luc; Rakotomahenina, Hajanirina; Carcopino, Xavier.
Afiliação
  • Demarquet E; Department of Obstetrics and Gynaecology, Hôpital Nord, APHM, Aix-Marseille University (AMU), Univ Avignon, CNRS, IRD, IMBE UMR, Marseille, France.
  • Mancini J; Aix Marseille University, Inserm, IRD, UMR S1252, SESSTIM, Marseille, France.
  • Preaubert L; APHM, Hôpital de la Timone, Public Health Department, BioSTIC, Marseille, France.
  • Gondry J; Department of Obstetrics and Gynaecology, Hôpital Nord, APHM, Aix-Marseille University (AMU), Univ Avignon, CNRS, IRD, IMBE UMR, Marseille, France.
  • Chevreau J; University Hospital of Amiens, Jules Verne University, Picardie, France.
  • Lamblin G; University Hospital of Amiens, Jules Verne University, Picardie, France.
  • Lebail K; Department of Obstetrics and Gynaecology, Femme Mère Enfant University Hospital, Lyon-Bron, France.
  • Lavoué V; Department of Obstetrics and Gynaecology, Femme Mère Enfant University Hospital, Lyon-Bron, France.
  • Pinsard M; Teaching hospital of Rennes, Gynaecologic Department, University of Rennes 1, Rennes, France.
  • Baldauf JJ; Teaching hospital of Rennes, Gynaecologic Department, University of Rennes 1, Rennes, France.
  • Bryand A; Department of Obstetrics and Gynaecology, Hospital of Hautepierre, Strasbourg University Hospitals, Strasbourg, France.
  • Henno S; Department of Obstetrics and Gynaecology, Hospital of Hautepierre, Strasbourg University Hospitals, Strasbourg, France.
  • Agostini A; Department of Pathology, CHU Pontchaillou, Rennes, France.
  • Douvier S; Department of Obstetrics and Gynaecology, Hôpital La Conception, APHM, Aix-Marseille University (AMU), Marseille, France.
  • Jarniat A; Department of Gynaecologic and Oncologic Surgery, CHU Dijon, France.
  • Riethmuller D; Department of Gynaecologic and Oncologic Surgery, CHU Dijon, France.
  • Mendel A; Pôle Mère-Femme, University Hospital Jean Minjoz, Besançon, France.
  • Brun JL; Pôle Mère-Femme, University Hospital Jean Minjoz, Besançon, France.
  • Rakotomahenina H; Pôle d'Obstétrique Reproduction Gynécologie, Centre Aliénor d'Aquitaine, Hôpital Pellegrin, Bordeaux, France.
  • Carcopino X; Pôle d'Obstétrique Reproduction Gynécologie, Centre Aliénor d'Aquitaine, Hôpital Pellegrin, Bordeaux, France.
J Low Genit Tract Dis ; 23(1): 18-23, 2019 Jan.
Article em En | MEDLINE | ID: mdl-30085949
OBJECTIVE: The aim of the study was to identify the risk factors of post-large loop excision of the transformation zone (LLETZ) recurrent disease and the impact of colposcopic guidance at the time of LLETZ on that risk. MATERIALS AND METHODS: From December 2013 to July 2014, 204 patients who had undergone LLETZ for the treatment of high-grade intraepithelial lesion with fully visible cervical squamocolumnar junction were included. The use of colposcopy during each procedure was systematically documented. The dimensions and volume of LLETZ specimens were measured at the time of the procedure before formaldehyde fixation. All participants were invited for a follow-up. The primary endpoint was the diagnosis of post-LLETZ recurrent disease defined as the histologic diagnosis of a high-grade cervical intraepithelial lesion. RESULTS: The median duration of post-LLETZ follow-up was 25.8 months. Recurrent disease was diagnosed in 8 (3.6%) patients. Older than 38 years (adjusted hazard ratio [aHR] = 11.9, 95% CI = 1.6-86.0), history of excisional therapy (aHR = 21.6, 95% CI = 3.5-135.3), and the absence of colposcopy for the guidance of LLETZ (aHR = 6.4, 95% CI = 1.1-37.7) were found to significantly increase the risk of post-LLETZ recurrent disease. The dimensions and volume of the specimen were not found to have any impact. Only positive endocervical margins were identified to significantly increase the risk of post-LLETZ recurrent disease (aHR = 14.4, 95% CI = 2.0-101.1). CONCLUSIONS: Risk factors of post-LLETZ recurrent disease are older than 38 years, history of excisional therapy, positive endocervical margins, and lack of colposcopic guidance at the time of LLETZ.
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Transformação Celular Neoplásica / Neoplasias do Colo do Útero / Lesões Intraepiteliais Escamosas Cervicais / Margens de Excisão Tipo de estudo: Etiology_studies / Guideline / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Adult / Aged / Female / Humans / Middle aged Idioma: En Ano de publicação: 2019 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Transformação Celular Neoplásica / Neoplasias do Colo do Útero / Lesões Intraepiteliais Escamosas Cervicais / Margens de Excisão Tipo de estudo: Etiology_studies / Guideline / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Adult / Aged / Female / Humans / Middle aged Idioma: En Ano de publicação: 2019 Tipo de documento: Article