Gynecologic and obstetric investigation · 2014
The overtreatment risk of see-and-treat strategy in management of abnormal cervical cytology.
СтатьяНазвание и аннотация: Перевод в очереди
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Kim Ji Ye, Lee Doo Haeng, Kang Jun Hyeok, Kim Kye Hyun, Lee Kyo Won, Kim Woo Young
Аннотация
BACKGROUND: To evaluate the feasibility of conization without a prior punch biopsy for patients with abnormal cytology.
METHODS: A retrospective review was performed for 700 patients who underwent conization at a single institution from January 2003 to August 2012. Each of these patients was assigned to one of two groups, either the 'see-and-treat' group or the 'three-step' group, depending on whether the patient had undergone a punch biopsy before conization or not. The final histologic results of two groups were compared.
RESULTS: The overtreatment risk was higher in the 'see-and-treat' group in patients with atypical squamous cells of undetermined significance/low-grade squamous intraepithelial lesion (ASCUS/LSIL) cytology (64.7% in the 'see-and-treat' group vs. 36.5% in the 'three-step' group; p = 0.001). There was no significant statistical difference in the rate of cervical dysplasia or invasive carcinoma in patients with high-grade squamous intraepithelial lesion (HSIL) cytology between groups (91.8% in the 'see-and-treat' group vs. 93.5% in the 'three-step' group; p = 0.793).
CONCLUSION: The patients with HSIL on cytology can be managed by a 'see-and-treat' strategy with a low risk of overtreatment. On the other hand, the 'three-step' management is more appropriate in patients with ASCUS/LSIL cytology.
METHODS: A retrospective review was performed for 700 patients who underwent conization at a single institution from January 2003 to August 2012. Each of these patients was assigned to one of two groups, either the 'see-and-treat' group or the 'three-step' group, depending on whether the patient had undergone a punch biopsy before conization or not. The final histologic results of two groups were compared.
RESULTS: The overtreatment risk was higher in the 'see-and-treat' group in patients with atypical squamous cells of undetermined significance/low-grade squamous intraepithelial lesion (ASCUS/LSIL) cytology (64.7% in the 'see-and-treat' group vs. 36.5% in the 'three-step' group; p = 0.001). There was no significant statistical difference in the rate of cervical dysplasia or invasive carcinoma in patients with high-grade squamous intraepithelial lesion (HSIL) cytology between groups (91.8% in the 'see-and-treat' group vs. 93.5% in the 'three-step' group; p = 0.793).
CONCLUSION: The patients with HSIL on cytology can be managed by a 'see-and-treat' strategy with a low risk of overtreatment. On the other hand, the 'three-step' management is more appropriate in patients with ASCUS/LSIL cytology.