Objectives: Cervical adenocarcinoma in situ (AIS) is a precursor of invasive disease that is increasing in incidence primarily among reproductive-age women of low parity. Conization is an alternative to hysterectomy that allows future pregnancy, but has an inherent risk of residual AIS. The purpose of this study was to determine the outcomes of patients treated by this fertility-sparing strategy over an extended period of surveillance.
Methods: Women diagnosed with cervical AIS who underwent primary fertility-sparing surgery with either loop excision or cold knife conization between 1993 and 2001 were identified at three institutions. A retrospective medical record review was performed. Patients 40 years of age and older and those undergoing hysterectomy within 12 months of diagnosis were excluded.
Results: A total of 101 women underwent cone biopsy and expectant management. The median age was 29 years. Fifty-seven percent were nulliparous and 23% primiparous. Cold knife conization was most commonly performed (69 vs. 32 procedures) and had a higher efficacy of achieving negative margins (72% vs. 47%; P=0.036). Thirty-five women had a total of 49 pregnancies during a mean follow-up of 51 months. Thirty-five gestations were delivered at term. There were two preterm births, eight spontaneous miscarriages, three elective terminations, and one ectopic pregnancy. Thirty-six patients had a repeat cone biopsy. Five ultimately underwent hysterectomy. No invasive cervical adenocarcinomas were observed during the study interval.
Conclusion: Fertility-sparing surgery enables women with cervical AIS to achieve pregnancy with minimal risk of developing invasive disease during surveillance.
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http://dx.doi.org/10.1016/j.ygyno.2007.06.021 | DOI Listing |
Int J Gynecol Cancer
January 2025
Gustave-Roussy Cancer Campus, Department of Gynecologic Surgery, Villejuif, France; University Paris Saclay, Le Kremlin-Bicêtre, France.
Int J Gynecol Cancer
January 2025
Department of Gynecology, European Institute of Oncology, IEO, IRCCS, Milan, Italy. Electronic address:
Objective: No biomarkers are available to predict treatment response in patients with endometrial cancers who undergo fertility-sparing treatment. Therefore, we aimed to evaluate the prognostic role of molecular classification.
Methods: Patients with endometrial cancer who underwent fertility-sparing treatment with progestins between 2005 and 2021 were retrospectively identified.
Int J Gynecol Cancer
January 2025
Nazionale dei Tumori di Milano, Fondazione IRCCS Istituto Gynecological Oncology Unit, Milan, Italy.
Objective: Endometrial cancers can be classified into 4 molecular sub-groups: (1) POLE mutated (POLEmut), (2) mismatch repair deficiency/microsatellite-instable (MMRd/MSI-H), (3) TP53-mutant or p53 abnormal (p53abn), and (4) no specific mutational profile (NSMP). Although molecular classification is increasingly applied in oncology, its role in guiding fertility-sparing treatments for endometrial cancer remains unclear. This study examines the prognostic role of molecular classification in fertility-sparing treatment and its potential to guide treatment decisions.
View Article and Find Full Text PDFCureus
December 2024
2nd Pediatric Surgery Department, Athens Children's Hospital P&A Kyriakou, Athens, GRC.
Juvenile granulosa cell tumors (JGCTs), a rare type of ovarian tumor, are predominantly seen in premenarchal girls. We report a case of a 4.5-year-old girl with precocious puberty and a left ovarian JGCT, confirmed through imaging and histopathology.
View Article and Find Full Text PDFZhonghua Fu Chan Ke Za Zhi
January 2025
Department of Gynecology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing100021, China.
To analyze the clinical characteristics, treatments, and prognosis of patients with ovarian juvenile granulosa cell tumor (JGCT). Clinical and pathological data, and follow-up information of 34 patients diagnosed with JGCT from 2000 to 2021 were collected from the surveillance, epidemiology, and end results (SEER) database. A retrospective analysis was conducted to summarize the patients' clinical and pathological characteristics, treatments, and prognosis.
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