Publications by authors named "Soutter W"

Objective: The aim of this study was to assess the effect of the excision margin after cone for stage Ia1 cervical cancer on long-term outcomes.

Study Design: Retrospective observational study. Patients were divided into 3 groups.

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Aim: To compare triage strategies using different human papillomavirus (HPV) consensus and genotyping tests and a p16(INK4a) test.

Methods: 1228 women referred with a borderline or single mildly dyskaryotic smear. Samples were taken at colposcopy using PreservCyt.

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Objective: To assess the level of compliance with follow-up over time after treatment for preinvasive and Stage Ia1 lesions of the cervix. To compare the average interval between visits with the interval prescribed by protocol and to evaluate the use of this difference as a measure of compliance.

Design: Retrospective observational study.

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High-risk human papillomavirus (HPV) DNA/RNA testing provides higher sensitivity but lower specificity than cytology for the identification of high-grade cervical intraepithelial neoplasia (CIN). Several new HPV tests are now available for this purpose, and a direct comparison of their properties is needed. Seven tests were evaluated with samples in liquid PreservCyt transport medium from 1,099 women referred for colposcopy: the Hybrid Capture 2 (Qiagen), Cobas (Roche), PreTect HPV-Proofer (NorChip), Aptima HPV (Gen-Probe), and Abbott RealTime assays, the BD HPV test, and CINtec p16(INK4a) cytology (mtm laboratories) immunocytochemistry.

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Objective: To determine the important factors affecting the long-term failure rate of treatment for cervical intraepithelial neoplasia (CIN).

Design: Multivariate analysis of prospectively collected clinical data.

Setting: Colposcopy clinic in a university teaching hospital.

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Objective: To determine whether there is a node count which can define an adequate inguinofemoral lymphadenectomy (IFL) in primary VSCC.

Methods: A retrospective and prospective review of patients with node negative VSCC who had a full staging IFL. Detection of isolated groin recurrences (IGR) would allow groins with higher risk of groin recurrence to be identified.

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HPV DNA testing is known to be much more sensitive than cytology, but less specific. A range of HPV and related tests in 858 women referred for colposcopy because of an abnormal smear were evaluated to compare the performances of these tests. This article compared the Abbott test to other tests which had been previously evaluated.

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Screening for preinvasive disease of the cervix, and detecting and mapping the lesions for treatment, are fundamental to programs for the prevention of cervical cancer. These will become even more important in women vaccinated against humanpapilloma viruses 16 and 18. Biophysical imaging technologies have considerable potential advantages in both screening for and mapping the lesions.

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Purpose: Colposcopy occupies a key role in the prevention of cervical cancer by identifying preinvasive or invasive lesions. However, colposcopy is subjective and is responsible for 52% of screening failures. Dynamic spectral imaging (DSI) is based on the objective, quantitative assessment of the acetowhitening effect.

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Several studies have shown that HPV testing is substantially more sensitive than cytology for primary cervical screening. However, less data exist concerning the duration of protection afforded by a negative HPV test compared to a normal cytological outcome. Here we report the long-term findings from the Hammersmith study in women aged 35 or more.

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Background: Over 60,000 women are treated for cervical intraepithelial neoplasia (CIN) each year in England, most by excision. Management of women who have incomplete excision is controversial and the subject of much debate. Consequently, the completeness of excision is often ignored in the planning of subsequent treatment.

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Background: About 50,000 women are referred annually to colposcopy in England because of a low-grade smear. About 35% of these women have no colposcopic abnormality but are followed up in the colposcopy clinic because of uncertainty about the risk of significant pathology.

Objective: This study determined the 5-year rate of disease when initial colposcopy was normal and smear was non-dyskaryotic.

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Objective: To determine the effect of colposcopy on the sensitivity and specificity of follow-up procedures in the detection of residual or recurrent disease after treatment for cervical intraepithelial neoplasia (CIN).

Design: A retrospective study of information held in a colposcopy database.

Setting: A teaching hospital colposcopy clinic.

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Background: Estimation of tumor volume by endovaginal magnetic resonance (MR) imaging is a better indicator of prognosis than FIGO stage in women with cervical cancer treated by standard modalities. However, the introduction of fertility conserving surgical techniques makes fresh demands upon imaging of these small tumors.

Objective: To determine the sensitivity and specificity of endovaginal MRI in detecting small volume disease and assessing parametrial extension in uterine cervical cancer by comparing the findings with those at radical hysterectomy in order to establish its role in guiding the surgical decision-making process preoperatively.

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Invasive cancer of the cervix after treatment for cervical intraepithelial neoplasia (CIN) is becoming more important, as screening reduces the incidence of invasive disease. The rate of invasive cervical or vaginal cancer following treatment for CIN in UK remains elevated for at least 8 years. The aim of our study was to determine from international data how long this rate remains elevated and whether the rate of invasive disease reflects the rate of posttreatment CIN.

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Background: The prevalence of cervical cancer is extremely high in low income countries, primarily because of a lack of cytological screening. The link between human papillomavirus (HPV) and cervical cancer has long been recognised, and it has been suggested that isolated HPV testing in women who do not participate in existing screening programmes may be used to identify women at higher risk of developing cervical cancer. This community based study compares two self administered techniques for detecting HPV (tampons and self administered swabs) with a clinician directed technique, the cervical cytobrush.

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Objective: We sought to describe MDCT and MRI features and tumor marker levels that differentiate borderline ovarian tumors from stage I ovarian tumors.

Conclusion: Borderline ovarian tumors are complex masses with imaging features similar to stage I tumors. The thickness of septations and the size of solid components are significantly larger in stage I tumors, and these features may be helpful for predicting likelihood of invasive tumors.

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Overall, about one-third of women operated upon because of suspected ovarian cancer turn out to have benign disease. This proportion will be even higher when the tumours are small. A more accurate method of determining which are malignant would reduce the number of unnecessary referrals to the cancer centre and increase the scope for conservative management.

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Objective: To determine whether lower rates or incomplete resection of cervical intraepithelial neoplasia (CIN) may be achieved by needle excision of the transformation zone (NETZ) than with loop excision (LLETZ).

Design: A prospective randomised controlled trial.

Setting: A gynaecological oncology centre and a teaching hospital in West London.

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