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The top hat procedure does not impact the management of women treated by LEEP in cervical cancer screening.
Yoneda, Juliana Yoko; Santiago, Aline Evangelista; Teixeira, Julio Cesar; Machado, Helymar Costa; Derchain, Sophie; Yonamine, Milena; Vale, Diama Bhadra.
Afiliação
  • Yoneda JY; Universidade de Campinas Department of Obstetrics and Gynecology CampinasSP Brazil Department of Obstetrics and Gynecology, Universidade de Campinas, Campinas, SP, Brazil.
  • Santiago AE; Universidade de Santo Amaro Medicine School São PauloSP Brazil Medicine School, Universidade de Santo Amaro, São Paulo, SP, Brazil.
  • Teixeira JC; Universidade de Campinas Department of Obstetrics and Gynecology CampinasSP Brazil Department of Obstetrics and Gynecology, Universidade de Campinas, Campinas, SP, Brazil.
  • Machado HC; Universidade de Campinas Department of Obstetrics and Gynecology CampinasSP Brazil Department of Obstetrics and Gynecology, Universidade de Campinas, Campinas, SP, Brazil.
  • Derchain S; Universidade de Campinas Department of Obstetrics and Gynecology CampinasSP Brazil Department of Obstetrics and Gynecology, Universidade de Campinas, Campinas, SP, Brazil.
  • Yonamine M; Universidade de Campinas Department of Obstetrics and Gynecology CampinasSP Brazil Department of Obstetrics and Gynecology, Universidade de Campinas, Campinas, SP, Brazil.
  • Vale DB; Universidade de Campinas Department of Obstetrics and Gynecology CampinasSP Brazil Department of Obstetrics and Gynecology, Universidade de Campinas, Campinas, SP, Brazil.
Rev Bras Ginecol Obstet ; 462024.
Article em En | MEDLINE | ID: mdl-39381338
ABSTRACT

Objective:

To describe Top-hat results and their association with margin status and disease relapse in a referral facility in Brazil.

Methods:

A retrospective study of 440 women submitted to LEEP to treat HSIL, in which 80 cases were complemented immediately by the top hat procedure (Top-hat Group - TH). TH Group was compared to women not submitted to Top-hat (NTH). The sample by convenience included all women that underwent LEEP from January 2017 to July 2020. The main outcome was the histological result. Other variables were margins, age, transformation zone (TZ), depth, and relapse. The analysis used the Chi-square test and logistic regression.

Results:

The TH Group was predominantly 40 and older (NTH 23.1% vs. TH 65.0%, p<0.001). No difference was found in having CIN2/CIN3 as the final diagnosis (NTH 17.0% vs. TH 21.3%, p=0.362), or in the prevalence of relapse (NTH 12.0% vs. TH 9.0%, p=0.482). Of the 80 patients submitted to top hat, the histological result was CIN2/CIN3 in eight. A negative top hat result was related to a negative endocervical margin of 83.3%. A CIN2/CIN3 Top-hat result was related to CIN2/CIN3 margin in 62.5% (p=0.009). The chance of obtaining a top hat negative result was 22.4 times higher (2.4-211.0) when the endocervical margin was negative and 14.5 times higher (1.5-140.7) when the ectocervical margin was negative.

Conclusion:

The top hat procedure did not alter the final diagnosis of LEEP. No impact on relapse was observed. The procedure should be avoided in women of reproductive age.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Neoplasias do Colo do Útero Limite: Adult / Female / Humans / Middle aged País/Região como assunto: America do sul / Brasil Idioma: En Revista: Rev Bras Ginecol Obstet Assunto da revista: GINECOLOGIA / OBSTETRICIA Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Brasil País de publicação: Brasil
Texto completo
Adicionar na Minha BVS
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Neoplasias do Colo do Útero Limite: Adult / Female / Humans / Middle aged País/Região como assunto: America do sul / Brasil Idioma: En Revista: Rev Bras Ginecol Obstet Assunto da revista: GINECOLOGIA / OBSTETRICIA Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Brasil País de publicação: Brasil