Cancers · 2025
Metastatic Carcinomas at the Episiotomy Site: A Systematic Literature Review.
СтатьяОбзорНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Palicelli Andrea, Tonni Gabriele, Torricelli Federica, Melli Beatrice, Cusenza Vincenza Ylenia, Martinelli Sandra, Zanetti Eleonora, Bisagni Alessandra, Zanelli Magda, Bonasoni Maria Paola, Rossi Teresa, Mangone Lucia, Medina-Illueca Venus Damaris, Zizzo Maurizio, Morini Andrea, Broggi Giuseppe, Caltabiano Rosario, Salzano Serena, Sanguedolce Francesca, Koufopoulos Nektarios I, Boutas Ioannis, Asaturova Aleksandra, Casartelli Chiara, Rubagotti Sara, Crotti Matteo, Aguzzoli Lorenzo, Mandato Vincenzo Dario
Аннотация
Background/Objectives: Rarely, primary (PriCs) or metastatic (metECs) carcinomas occur in the episiotomy site. Methods: A systematic literature review of metECs was carried out. We reviewed the PRISMA guidelines and the Scopus, Pubmed, and Web of Science databases. Results: We found 21 carcinomas; all of them were cervical carcinomas (11 squamous, SCC; 6 adenocarcinomas; 3 adenosquamous; 1 SCC or adenocarcinoma) diagnosed during pregnancy (38%) or 0.25-8 months postpartum (57%). SCCs were larger (mean size: 4.8 cm). At presentation, only two cases were pN+, and no distant metastases were found, excluding four episiotomy metastases (one anticipating the cervical cancer diagnosis); the remaining episiotomy metastases (mean size: 3 cm; one multifocal) were found at follow-up (these were first metastases in 86% of cases). The time range from the episiotomy/last delivery to first episiotomy metastasis was 1-66 (mean, 12.3) months. Treatment was variable: hysterectomy (71%) ± lymphadenectomy (67%) and/or adjuvant treatment (19%); chemoradiation/radiotherapy alone (24%). A total of 90% of cases recurred after 18 days to 66 months (mean, 12 months). At last follow-up, ten patients (48%) were disease-free after 12-120 (mean, 63.5) months, two patients (10%) were alive with disease, and nine (42%) patients died of disease after 6-36 (mean, 12.5) months (including two never-cleared/progressing cases). Conclusions: PriCs and metECs are rare. Iatrogenic/obstetric implantation or vascular dissemination of cervical cancer at the site of episiotomy may occur. For episiotomy lesions, accurate gynecological/perineal examination is required, and biopsy can be considered. Larger studies are required in order to determine treatment guidelines. Compared to PriCs, metECs occurred in younger (premenopausal) patients, were not associated with endometriosis, and demonstrated slightly smaller size and shorter mean time from episiotomy to episiotomy metastases, with a higher likelihood of a less favorable prognosis.