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01-11-2013 | General Gynecology

Impact of conization type on the resected cone volume: results of a retrospective multi-center study

Authors: Christoph Grimm, Lindsay Brammen, Gerhard Sliutz, Monika Weigert, Paul Sevelda, Sophie Pils, Alexander Reinthaller, Stephan Polterauer

Published in: Archives of Gynecology and Obstetrics | Issue 5/2013

Abstract

Purpose

The extent of conization seems to influence the risk of preterm birth. The aim of this study was to compare the cone volume after surgical resection with large loop excision of the transformation zone (LLETZ) and cold knife conization (CKC).

Methods

The present retrospective multi-center study comprises 804 consecutive women, who underwent LLETZ (n = 412) or CKC (n = 392) between 2004 and 2009. Univariate and multivariable analyses were performed to compare cone volumes removed by LLETZ and CKC and identify independent risk factors for large cone volume.

Results

The median resected cone volume after LLETZ was significantly smaller [1.6 cm³ (0.8–2.9)] than after CKC [2.1 cm³ (1.4–3.5)] (<0.0001). Complete resection rates were comparable in both groups. Conization method, cone depth, and institution type were independent risk factors for removal of a large cone volume.

Conclusion

CKC removes larger cone volumes than LLETZ without the advantage of higher complete resection rates.

Insinga RP, Glass AG, Rush BB (2004) Diagnoses and outcomes in cervical cancer screening: a population-based study. Am J Obstet Gynecol 191:105–113PubMedCrossRef

Wright TC Jr, Massad LS, Dunton CJ, Spitzer M, Wilkinson EJ, Solomon D (2007) 2006 American Society for Colposcopy and Cervical Pathology-sponsored Consensus Conference. 2006 consensus guidelines for the management of women with cervical intraepithelial neoplasia or adenocarcinoma in situ. Am J Obstet Gynecol 197:340–345PubMedCrossRef

Martin-Hirsch PP, Paraskevaidis E, Bryant A, Dickinson HO, Keep SL (2010) Surgery for cervical intraepithelial neoplasia. Cochrane Database Syst Rev 6:CD001318PubMed

Arbyn M, Kyrgiou M, Simoens C, Raifu AO, Koliopoulos G, Martin-Hirsch P, Prendiville W, Paraskevaidis E (2008) Perinatal mortality and other severe adverse pregnancy outcomes associated with treatment of cervical intraepithelial neoplasia: meta-analysis. BMJ 337:a1284PubMedCrossRef

Kyrgiou M, Koliopoulos G, Martin-Hirsch P, Arbyn M, Prendiville W, Paraskevaidis E (2006) Obstetric outcomes after conservative treatment for intraepithelial or early invasive cervical lesions: systematic review and meta-analysis. Lancet 367:489–498PubMedCrossRef

Sadler L, Saftlas A, Wang W, Exeter M, Whittaker J, McCowan L (2004) Treatment for cervical intraepithelial neoplasia and risk of preterm delivery. JAMA 291:2100–2106PubMedCrossRef

Phadnis SV, Atilade A, Young MP, Evans H, Walker PG (2010) The volume perspective: a comparison of two excisional treatments for cervical intraepithelial neoplasia (laser versus LLETZ). BJOG 117:615–619PubMedCrossRef

Leiman G, Harrison NA, Rubin A (1980) Pregnancy following conisation of the cervix: complications related to cone size. Am J Obstet Gynecol 136:14–18PubMed

Tseng CJ, Liang CC, Lin CT, Huang KG, Chou HH, Chang TC, Lai CH, Soong YK, Hsueh S (1999) A study of diagnostic failure of loop conisation in microinvasive carcinoma of the cervix. Gynecol Oncol 73:91–95PubMedCrossRef

10.

Ang C, Mukhopadhyay A, Burnley C, Faulkner K, Cross P, Martin-Hirsch P, Naik R (2011) Histological recurrence and depth of loop treatment of the cervix in women of reproductive age: incomplete excision versus adverse pregnancy outcome. BJOG 118:685–692PubMedCrossRef

11.

Ortoft G, Henriksen TB, Hansen ES, Petersen LK (2010) After conisation of the cervix, the perinatal mortality as a result of preterm delivery increase in subsequent pregnancy. BJOG 117:258–267PubMedCrossRef

12.

Khalid S, Dimitriou E, Conroy R, Paraskevaidis E, Kyrgiou M, Harrity C, Arbyn M, Prendiville W (2012) The thickness and volume of LLETZ specimens can predict the relative risk of pregnancy-related morbidity. BJOG 119:685–691PubMedCrossRef

Title: Impact of conization type on the resected cone volume: results of a retrospective multi-center study
Authors: Christoph Grimm
Lindsay Brammen
Gerhard Sliutz
Monika Weigert
Paul Sevelda
Sophie Pils
Alexander Reinthaller
Stephan Polterauer
Publication date: 01-11-2013
Publisher: Springer Berlin Heidelberg
Published in: Archives of Gynecology and Obstetrics / Issue 5/2013
Print ISSN: 0932-0067
Electronic ISSN: 1432-0711
DOI: https://doi.org/10.1007/s00404-013-2873-1

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Impact of conization type on the resected cone volume: results of a retrospective multi-center study

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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