Maria Kyrgiou1, George Valasoulis2, Sofia-Melina Stasinou3, Christina Founta4, Antonios Athanasiou5, Phillip Bennett6, Evangelos Paraskevadis5. 1. Department of Surgery and Cancer, Faculty of Medicine, Imperial College, London, UK; West London Gynecological Cancer Center, Queen Charlotte's and Chelsea-Hammersmith Hospital, Imperial Healthcare NHS Trust, London, UK. Electronic address: m.kyrgiou@imperial.ac.uk. 2. Department of Obstetrics and Gynecology-Gynecological Oncology, University Hospital of Ioannina, Ioannina, Greece; Department of Obstetrics and Gynaecology, Worthing Hospital, Western Sussex Hospitals NHS Foundation Trust, Worthing, UK. 3. Department of Obstetrics and Gynecology-Gynecological Oncology, University Hospital of Ioannina, Ioannina, Greece; IVF Unit, Queen Charlotte's and Chelsea-Hammersmith Hospital, Imperial Healthcare NHS Trust, London, UK. 4. Department of Obstetrics and Gynecology-Gynecological Oncology, University Hospital of Ioannina, Ioannina, Greece; Northern Gynecological Oncology Center, QE Gateshead NHS Trust, Gateshead, UK. 5. Department of Obstetrics and Gynecology-Gynecological Oncology, University Hospital of Ioannina, Ioannina, Greece. 6. Department of Surgery and Cancer, Faculty of Medicine, Imperial College, London, UK; West London Gynecological Cancer Center, Queen Charlotte's and Chelsea-Hammersmith Hospital, Imperial Healthcare NHS Trust, London, UK.
Abstract
OBJECTIVE: To assess how the proportion of the cervical volume/length removed during treatment for cervical intraepithelial neoplasia (CIN) varies and whether this correlates to the pregnancy duration at delivery. METHODS: The present prospective observational study included 142 women undergoing CIN treatment at a university hospital during 2009-2013. The pretreatment and post-treatment cervical dimensions and cone size were measured with magnetic resonance imaging, three-dimensional transvaginal ultrasonography, or two-dimensional transvaginal ultrasonography, and the correlation between pregnancy outcomes and the relative proportion of the cervix excised was assessed. RESULTS: Pretreatment cervical volumes and cone volumes varied substantially (range 11-40 cm(3) and 0.6-8 cm(3), respectively). The proportion of the volume excised ranged from 2.2% to 39.4%. Sixteen (11%) women conceived following treatment; 12 had a live birth (seven at term, three preterm). The pregnancy duration at delivery was significantly correlated with the proportion of the cervical volume (r=-0.9; P<0.001) and length (r=-0.7; P=0.01) excised and the cone volume (r=-0.6; P=0.04). CONCLUSION: The pretreatment cervical dimensions and the proportions of the volume/length excised vary substantially, and the latter correlates with the pregnancy duration. Assessment of the proportion excised might help to stratify women at risk who need intensive surveillance when pregnant.
OBJECTIVE: To assess how the proportion of the cervical volume/length removed during treatment for cervical intraepithelial neoplasia (CIN) varies and whether this correlates to the pregnancy duration at delivery. METHODS: The present prospective observational study included 142 women undergoing CIN treatment at a university hospital during 2009-2013. The pretreatment and post-treatment cervical dimensions and cone size were measured with magnetic resonance imaging, three-dimensional transvaginal ultrasonography, or two-dimensional transvaginal ultrasonography, and the correlation between pregnancy outcomes and the relative proportion of the cervix excised was assessed. RESULTS: Pretreatment cervical volumes and cone volumes varied substantially (range 11-40 cm(3) and 0.6-8 cm(3), respectively). The proportion of the volume excised ranged from 2.2% to 39.4%. Sixteen (11%) women conceived following treatment; 12 had a live birth (seven at term, three preterm). The pregnancy duration at delivery was significantly correlated with the proportion of the cervical volume (r=-0.9; P<0.001) and length (r=-0.7; P=0.01) excised and the cone volume (r=-0.6; P=0.04). CONCLUSION: The pretreatment cervical dimensions and the proportions of the volume/length excised vary substantially, and the latter correlates with the pregnancy duration. Assessment of the proportion excised might help to stratify women at risk who need intensive surveillance when pregnant.
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: P Sasieni; A Castanon; R Landy; M Kyrgiou; H Kitchener; M Quigley; Lcy Poon; A Shennan; A Hollingworth; W P Soutter; T Freeman-Wang; D Peebles; W Prendiville; J Patnick Journal: BJOG Date: 2015-12-23 Impact factor: 6.531
Authors: Diane E Halliwell; Maria Kyrgiou; Anita Mitra; Ilkka Kalliala; Evangelos Paraskevaidis; Georgios Theophilou; Pierre L Martin-Hirsch; Francis L Martin Journal: Sci Rep Date: 2016-12-15 Impact factor: 4.379
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: Christine Colie; Katherine G Michel; Leslie S Massad; Cuiwei Wang; Gypsyamber DʼSouza; Lisa Rahangdale; Lisa Flowers; Joel Milam; Joel M Palefsky; Howard Minkoff; Howard D Strickler; Seble G Kassaye Journal: J Acquir Immune Defic Syndr Date: 2018-12-15 Impact factor: 3.771
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