OBJECTIVE: To determine how the proportion of the cervical volume excised affects cervical regeneration. DESIGN: Prospective observational study. SETTING: University Hospital. POPULATION: Women planning to undergo excisional treatment for cervical intraepithelial neoplasia who wish to have future pregnancies. METHODS: The cervical volume (and dimensions) is calculated with magnetic resonance imaging (MRI) before treatment. The volume (and dimensions) of the cone is assessed before fixation by a volumetric tube and a ruler; the percentage (%) of excision is computed. Cervical regeneration is estimated by repeat MRI at 6 months. MAIN OUTCOME MEASURES: Cervical regeneration in relation to proportion of excision. Statistical analysis was performed by box plots and analysis of variance. RESULTS: A total of 48 women have been recruited; 29 have completed 6 months follow up. Both the total cervical volume (from MRI) before treatment and the volume of the excised/ablated cone varied substantially. The estimated proportion of excision varied significantly between 4% and 39% (median 11%). Multivariate linear regression revealed that the proportional deficit at 6 months post-treatment was determined mainly by the proportion of the excised volume. CONCLUSIONS: Careful assessment of risks and benefits of treatment is essential when deciding to treat women who wish to have future pregnancies. Assessment of the proportion of the cervical volume and length excised might identify those that need further surveillance during future pregnancy.
OBJECTIVE: To determine how the proportion of the cervical volume excised affects cervical regeneration. DESIGN: Prospective observational study. SETTING: University Hospital. POPULATION: Women planning to undergo excisional treatment for cervical intraepithelial neoplasia who wish to have future pregnancies. METHODS: The cervical volume (and dimensions) is calculated with magnetic resonance imaging (MRI) before treatment. The volume (and dimensions) of the cone is assessed before fixation by a volumetric tube and a ruler; the percentage (%) of excision is computed. Cervical regeneration is estimated by repeat MRI at 6 months. MAIN OUTCOME MEASURES: Cervical regeneration in relation to proportion of excision. Statistical analysis was performed by box plots and analysis of variance. RESULTS: A total of 48 women have been recruited; 29 have completed 6 months follow up. Both the total cervical volume (from MRI) before treatment and the volume of the excised/ablated cone varied substantially. The estimated proportion of excision varied significantly between 4% and 39% (median 11%). Multivariate linear regression revealed that the proportional deficit at 6 months post-treatment was determined mainly by the proportion of the excised volume. CONCLUSIONS: Careful assessment of risks and benefits of treatment is essential when deciding to treat women who wish to have future pregnancies. Assessment of the proportion of the cervical volume and length excised might identify those that need further surveillance during future pregnancy.
Authors: Shayna N Conner; Alison G Cahill; Methodius G Tuuli; David M Stamilio; Anthony O Odibo; Kimberly A Roehl; George A Macones Journal: Obstet Gynecol Date: 2013-12 Impact factor: 7.661
Authors: James Dickinson; Eva Tsakonas; Sarah Conner Gorber; Gabriela Lewin; Elizabeth Shaw; Harminder Singh; Michel Joffres; Richard Birtwhistle; Marcello Tonelli; Verna Mai; Meg McLachlin Journal: CMAJ Date: 2013-01-07 Impact factor: 8.262
Authors: Maria Kyrgiou; Ilkka E J Kalliala; Anita Mitra; Christina Fotopoulou; Sadaf Ghaem-Maghami; Pierre Pl Martin-Hirsch; Margaret Cruickshank; Marc Arbyn; Evangelos Paraskevaidis Journal: Cochrane Database Syst Rev Date: 2017-01-26
Authors: Maria Kyrgiou; Anita Mitra; Marc Arbyn; Sofia Melina Stasinou; Pierre Martin-Hirsch; Phillip Bennett; Evangelos Paraskevaidis Journal: BMJ Date: 2014-10-28
Authors: Antonios Athanasiou; Areti Angeliki Veroniki; Orestis Efthimiou; Ilkka Kalliala; Huseyin Naci; Sarah Bowden; Maria Paraskevaidi; Pierre Martin-Hirsch; Philip Bennett; Evangelos Paraskevaidis; Georgia Salanti; Maria Kyrgiou Journal: BMJ Open Date: 2019-10-21 Impact factor: 2.692
Authors: Maria Kyrgiou; Anita Mitra; Marc Arbyn; Maria Paraskevaidi; Antonios Athanasiou; Pierre P L Martin-Hirsch; Phillip Bennett; Evangelos Paraskevaidis Journal: Cochrane Database Syst Rev Date: 2015-09-29
Authors: Maria Kyrgiou; Antonios Athanasiou; Maria Paraskevaidi; Anita Mitra; Ilkka Kalliala; Pierre Martin-Hirsch; Marc Arbyn; Phillip Bennett; Evangelos Paraskevaidis Journal: BMJ Date: 2016-07-28
Authors: Andrea Ciavattini; Giovanni Delli Carpini; Lorenzo Moriconi; Nicolò Clemente; Nina Montik; Rosa De Vincenzo; Anna Del Fabro; Monica Buttignol; Caterina Ricci; Francesca Moro; Francesco Sopracordevole Journal: BMJ Open Date: 2018-03-19 Impact factor: 2.692
Authors: Antonios Athanasiou; Areti Angeliki Veroniki; Orestis Efthimiou; Ilkka Kalliala; Huseyin Naci; Sarah Bowden; Maria Paraskevaidi; Pierre Martin-Hirsch; Philip Bennett; Evangelos Paraskevaidis; Georgia Salanti; Maria Kyrgiou Journal: BMJ Open Date: 2019-08-02 Impact factor: 2.692