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Efficacy and Long-term Outcomes of Repeated Large Loop Excision of the Transformation Zone of the Cervix.
van de Sande, Anna J M; Schreuder, Coen M; van Baars, Romy; Koeneman, Margot M; Gerestein, Cornelis G; Kruse, Arnold-Jan; van Kemenade, Folkert J; Willemsen, Sten P; van Beekhuizen, Heleen J.
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  • van de Sande AJM; Department of Gynecological Oncology, the Department of Pathology, the Department of Epidemiology, and the Department of Biostatistics, Erasmus MC Cancer Institute, Rotterdam, the Department of Obstetrics and Gynecology, Maastricht University Medical Centre, Maastricht, the Department of Gynecological Oncology, Utrecht Cancer Center, University Medical Center Utrecht, Utrecht, and the Department of Obstetrics and Gynecology, Isala Clinics, Zwolle, the Netherlands.
Obstet Gynecol ; 139(3): 417-422, 2022 03 01.
Article en En | MEDLINE | ID: mdl-35115479
OBJECTIVE: To evaluate the efficacy and long-term outcome of repeat large loop excision of the transformation zone in women with residual or recurrent cervical intraepithelial neoplasia. METHODS: PALGA (the Dutch Pathology Registry), a database of deidentified cervical cytologic and histologic data, was used to examine women with cervical dysplasia who underwent two or more large loop excision of the transformation zone procedures between January 2005 and June 2015. We obtained cervical cytology and histology results. The main outcome was efficacy of repeated large loop excision of the transformation zone procedure in women with residual or recurrent cervical intraepithelial neoplasia. We also examined subsequent excisional procedures and hysterectomy. RESULTS: We identified 499 women who had undergone two or more large loop excision of the transformation zone procedures. After their second procedure, 60.7% of women had a normal first cervical cytologic sample. The mean duration of follow-up was 68 months (0-163 months). Additional cervical excisional procedures were performed in 33.7% of women. Overall, 1.2% of women developed cervical cancer during follow-up. Moreover, 19.0% of women eventually underwent hysterectomy. CONCLUSION: One third of the women who undergo two large loop excision of the transformation zone procedures require an additional excisional procedure or hysterectomy. Almost one fifth of these women eventually undergo hysterectomy.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Reoperación / Displasia del Cuello del Útero / Neoplasias del Cuello Uterino / Cuello del Útero / Neoplasia Residual / Recurrencia Local de Neoplasia Tipo de estudio: Observational_studies / Prognostic_studies Límite: Adult / Aged / Female / Humans / Middle aged Idioma: En Revista: Obstet Gynecol Año: 2022 Tipo del documento: Article País de afiliación: Países Bajos Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Reoperación / Displasia del Cuello del Útero / Neoplasias del Cuello Uterino / Cuello del Útero / Neoplasia Residual / Recurrencia Local de Neoplasia Tipo de estudio: Observational_studies / Prognostic_studies Límite: Adult / Aged / Female / Humans / Middle aged Idioma: En Revista: Obstet Gynecol Año: 2022 Tipo del documento: Article País de afiliación: Países Bajos Pais de publicación: Estados Unidos