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BMC Womens Health 2021 May 7;21(1):191. Epub 2021 May 7.

Department of Gynecological Oncology, Tianjin Central Hospital of Gynecology and Obstetrics, Tianjin, 300100, China.

Background: 20-25% of women with high-grade cervical intraepithelial neoplasias (HSIL) have residual lesions after conization. The state of the margin is generally considered to be a risk factor for recurrence or persistent lesions. Predictors of positive margins and residual lesions need to be identified. Read More

Vaccines (Basel) 2021 Apr 21;9(5). Epub 2021 Apr 21.

Department of Gynecologic Oncology, IRCCS National Cancer Institute, 20133 Milan, Italy.

Objective: The aim of this meta-analysis was to discuss evidence supporting the efficacy of adjuvant human papillomavirus (HPV) vaccination in reducing the risk of recurrent cervical intraepithelial neoplasia (CIN) 2 or greater after surgical treatment.

Methods: A systematic literature search was performed for studies reporting the impact of HPV vaccination on reducing the risk of recurrence of CIN 2+ after surgical excision. Results were reported as mean differences or pooled odds ratios (OR) with 95% confidence intervals (95% CI). Read More

Ginekol Pol 2021 Apr 29. Epub 2021 Apr 29.

Department of Obstetrics and Gynecology, Women's Hospital Zhejiang University School of Medicine, China.

Objectives: Cervical conization could increase the risk of cervical insufficiency. This study systematically evaluated the value of prophylactic transvaginal cervical cerclage following cervical conization with regards to pregnancy outcome.

Material And Methods: We performed a systematic review of the literature, using Web of Science, and Embase, the published time ranged from the date that database established to December 2019. Read More

Ginekol Pol 2021 Apr 29. Epub 2021 Apr 29.

Kütahya Sağlık Bilimleri Üniversitesi, Evliya Çelebi Yerleşkesi Tavşanlı Yolu 10. Km Kütahya, Turkey.

Objectives: Possible discrepancies between the cervical smear, biopsy histology and loop electrosurgical excision procedure (LEEP) results of the same patient is a matter of debate in the literature. In this study, we investigate the degree to which these results differ, and the clinical reasons for these differences.

Material And Methods: With a retrospective design, cervical smear, cervical biopsy and LEEP results of patients were compared in terms of consistency. Read More

J Gynecol Obstet Hum Reprod 2021 Apr 19;50(9):102152. Epub 2021 Apr 19.

Assistance Publique-Hôpitaux de Paris, Service de Gynécologie-Obstétrique, Hôpital Louis Mourier, Colombes, France; Université de Paris, Paris, France; FHU PREMA, Paris and Colombes, France; Inserm UMR1137 IAME, Paris, France. Electronic address:

Background: Cervical insufficiency is thought to be responsible for 10% of preterm deliveries. Shirodkar cerclage is among the available techniques ranging from McDonald's to definitive procedures, however the indications for the prevention of preterm births and mid-trimester miscarriages are still poorly delineated.

Objective: To describe the characteristics, obstetrical and neonatal outcomes of pregnancies with Shirodkar cerclage procedures. Read More

Technol Health Care 2021 Apr 2. Epub 2021 Apr 2.

Department of Obstetrics and Gynecology, Kyungpook National University Chilgok Hospital, Daegu, Korea.

Bacground: Cervical stenoses are one of the main long-term consequences after conization of the uterine cervix.

Objective: The purpose of this study was to evaluate the safety and efficacy of a uterine cervix supporting device (Con-CapTM) in reducing uterine cervical stenosis after Loop Electrosurgical Excisional Procedure (LEEP).

Methods: We enrolled 112 patients who underwent LEEP between March 2017 to May 2019. Read More

J Rural Med 2021 Apr 1;16(2):91-97. Epub 2021 Apr 1.

Department of Obstetrics and Gynecology, Yuri-kumiai General Hospital, Japan.

This study aimed to examine whether genotype categories of high-risk human papillomaviruses (HR-HPVs), when divided into HPV16/18, HPV 31/33/45/52/58, and HPV35/39/51/56/59/68, had an effect on the time required for and the proportion of cases that progressed to cervical intraepithelial neoplasia (CIN) grade 3 among women with CIN2. A total of 160 women aged 20-49 years and having CIN2 were recruited between January 2008 and June 2018. The time required for progression to CIN3 was determined by Kaplan-Meier time-to-event analysis. Read More

J Obstet Gynaecol India 2021 Feb 10;71(1):66-71. Epub 2020 Sep 10.

Department of Obstetrics and Gynecology, Faculty of Medicine, Kagoshima University Hospital, 8-35-1 Sakuragaoka, Kagoshima, 890-8520 Japan.

Objective: This study aimed to examine the associations of cone margin and human papillomavirus (HPV) status after conization with cytological abnormalities and disease recurrence in patients with cervical intraepithelial neoplasia grade 3 (CIN3).

Methods: This is a retrospective study of 366 women with CIN3 who underwent conization at Kagoshima University Hospital between 2004 and 2017. Conization was performed using an ultrasonic scalpel. Read More

Tissue Eng Part A 2021 Apr 3. Epub 2021 Apr 3.

Saga University Faculty of Medicine Graduate School of Medical Sciences, 38309, Pathology & Microbiology, Saga, Saga, Japan;

Cervical stenosis is a postoperative complication of conization for uterine cervical malignancy, but a standard method of preventing this complication has yet to be established. Collagen vitrigel is a collagen-based biomaterial that has anti-fibrotic and epithelization promoting actions. We evaluated the anti-stenotic effect of an indwelling collagen vitrigel membrane-coated nylon line (CVNL) following cervical conization in rabbits. Read More

Int J Gynaecol Obstet 2021 Mar 23. Epub 2021 Mar 23.

Department of Gynecology, Xiangya Hospital, Central South University, Changsha, China.

Objective: To explore treatment strategies for patients with positive margins after cervical cold knife conization (CKC) by estimating the risk of residual or recurrent CIN2 or worse (CIN2+).

Methods: A retrospective study included 569 patients receiving CKC for CIN3 in Xiangya Hospital from January 2013 to December 2017. Demographic characteristics and test results were obtained before CKC, after CKC, at 6, 12, and 24 months, then annually thereafter. Read More

Arch Gynecol Obstet 2021 Mar 19. Epub 2021 Mar 19.

Department of Obstetrics and Gynecology, Miyazaki Prefectural Miyazaki Hospital, 5-30 Kitatakamatsu, Miyazaki, Japan.

Purpose: Laser vaporization of the cervix is an established method of treating cervical intra-epithelial neoplasia, but its effect on subsequent pregnancies remains controversial. The aim of this study was to investigate pregnancy outcomes after laser vaporization.

Methods: We conducted a retrospective study involving women who delivered live singletons between 2012 and 2019 in a tertiary hospital. Read More

Ann Surg Oncol 2021 Mar 17. Epub 2021 Mar 17.

Department of Obstetrics and Gynecology, Clínica Universidad de Navarra, Madrid, Spain.

Int J Gynaecol Obstet 2021 Mar 15. Epub 2021 Mar 15.

Woman׳s Health Sciences Dept, Gynecologic Section, Università Politecnica delle Marche, Ancona, Italy.

Objective: To evaluate the risk factors for recurrence of high-grade disease after cervical excision in women living with HIV, with a specific interest in the role of HR-HPV positivity.

Methods: Multicentric retrospective study conducted on WLWH who underwent cervical excision between January 1987 and June 2017 in six Italian institutions. The rate of high-grade recurrence was determined. Read More

Prev Med 2021 Mar 4;144:106321. Epub 2021 Mar 4.

University of Cambridge, Cambridge, United Kingdom.

Prophylactic HPV vaccination has been a great public health success. For >20 years, clinical trials were conducted with the 2-, 4-, and/or 9-valent vaccines in young-adult females, mid-adult women, males, and adolescents. In all studies, the vaccines were highly efficacious, immunogenic, and well tolerated. Read More

Diagnostics (Basel) 2021 Feb 20;11(2). Epub 2021 Feb 20.

Department of Gastrointestinal Oncology, Osaka International Cancer Institute, Osaka 541-8567, Japan.

The current standard for diagnosing cervical intraepithelial neoplasia (CIN) is colposcopy followed by punch biopsy. We have developed flexible magnifying endoscopy with narrow band imaging (ME-NBI) for the diagnosis of CIN. Here, we investigated the feasibility of targeted endoscopic forceps biopsy (E-Bx) under guidance of ME-NBI for the diagnosis of CIN. Read More

Cancers (Basel) 2021 Feb 28;13(5). Epub 2021 Feb 28.

Department of Gynecologic Oncology, Netherlands Cancer Institute, Antoni van Leeuwenhoek, 1066 CX Amsterdam, The Netherlands.

Fertility-sparing surgery (FSS) is increasingly being offered to women with a gynecological malignancy who wish to preserve fertility. In this systematic review, we evaluate the best evidence currently available on oncological and reproductive outcome after FSS for early stage cervical cancer, epithelial ovarian cancer, and endometrial cancer. An extensive literature search was conducted using the electronic databases Medline (OVID), Embase, and Cochrane Library to identify eligible studies published up to December 2020. Read More

Oncol Lett 2021 Apr 31;21(4):240. Epub 2021 Jan 31.

Department of Women's and Children's Health, Obstetrics-Gynecology Division, Karolinska Institute, SE-17176 Stockholm, Sweden.

Women treated for high-grade cervical-intraepithelial-neoplasia (CIN) require long-term follow-up with high-risk human-papillomavirus (HPV) testing. Self-sampling for HPV is well-accepted among these patients, but its role in follow-up for this group requires investigation. The present study examined how well HPV findings from self-sampled vaginal (VSS) and urine specimens correctly identified women from this cohort with recurrent CIN2+ compared with samples collected by clinicians. Read More

Int J Gynecol Cancer 2021 Mar;31(3):457-461

Gynecologic Oncology, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy.

Introduction: To evaluate oncological and obstetrical outcomes of early stage cervical cancer patients who underwent conservative management to retain childbearing potential.

Methods: Data of women (aged <40 years) who underwent fertility sparing treatment for International Federation of Gynecology and Obstetrics (FIGO) stage IA1 with lymphovascular invasion (LVSI) and IB1 cervical cancer were prospectively collected. All patients underwent cervical conization/s and laparoscopic nodal evaluation (pelvic lymphadenectomy/sentinel node mapping). Read More

Int J Gynecol Cancer 2021 Mar;31(3):452-456

Department of Obstetrics and Gynecology, Gynaecologic Oncology Surgical Unit, ASST-Monza, San Gerardo Hospital, Monza, Italy.

Objective: Conization/simple trachelectomy is feasible in patients with early-stage cervical cancer. Retrospective data suggest that conization with negative lymph nodes could be a safe option for these patients. This study aims to provide oncologic and obstetric outcomes of a large series of patients with 2018 International Federation of Gynecology and Obstetrics (FIGO) stage IB1 cervical cancer managed by conization. Read More

Int J Gynecol Cancer 2021 Mar;31(3):447-451

Gynecologic Oncology, Odette Cancer Centre, Toronto, Ontario, Canada

Objective: There has been a contemporary shift in clinical practice towards tailoring treatment in patients with early cervical cancer and low-risk features to non-radical surgery. The objective of this study was to evaluate the oncologic, fertility, and obstetric outcomes after cervical conization and sentinel lymph node (SLN) biopsy in patients with early stage low-risk cervical cancer.

Methods: We conducted a retrospective review in patients with early cervical cancer treated with cervical conization and lymph node assessment between November 2008 and February 2020. Read More

Int J Gynecol Cancer 2021 Mar;31(3):387-398

Department of Gynecologic Oncology, Instituto Nacional de Cancerología, Bogota, Colombia

Background: Management of cervical cancer tumors >2 cm has been a subject of controversy, with management often considered as either up-front radical trachelectomy or neoadjuvant chemotherapy before fertility-sparing surgery.

Methods: A systematic literature review was conducted following the Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA) checklist. This study was registered in the International Prospective Register of Systematic Reviews (PROSPERO). Read More

Int J Gynecol Cancer 2021 Mar;31(3):379-386

Gynecologic and Obstetrics Department, Faculty of Medicine, Universidad de Concepción, Concepción, Chile.

Background: Neoadjuvant chemotherapy before fertility-sparing surgery is an accepted option for patients with cervical tumors between 2 cm and 4 cm. There is a paucity of data regarding its role in patients with tumors <2 cm. Our objective was to compare the oncological and obstetrical outcomes between patients who underwent neoadjuvant chemotherapy before cervical conization versus upfront cervical conization in patients with cervical cancer with tumors <2 cm. Read More

Zhonghua Fu Chan Ke Za Zhi 2021 Feb;56(2):114-120

Department of Obstetrics and Gynecology, the First Affiliated Hospital of Zhengzhou University, Henan Key Laboratory of Gynecological Cancer Prevention and Treatment Medicine, Zhengzhou 450052, China.

To analyze the characteristics of high-grade squamous intraepithelial lesion (HSIL) diagnosed by cervical tissue sampling in postmenopausal women. A retrospective study was performed on 2 013 patients with HSIL diagnosed by cervical tissue sampling under colposcopy and treated by cervical conization at the First Affiliated Hospital of Zhengzhou University from June 2017 to November 2018, to compare the difference of patients' clinical features, HPV test, liquid-based thin-layer cytology (TCT), performance of colposcopy and biopsy pathology, pathology after cervical conization between 439 postmenopausal patients and 1 574 pre-menopausal patients. (1) Clinical features: the proportion of contact bleeding showed no significant difference between postmenopausal patients and pre-menopausal patients [4. Read More

Ann Surg Oncol 2021 Feb 24. Epub 2021 Feb 24.

Dipartimento per la salute della Donna e del Bambino e della Salute Pubblica, IRCCS, UOC Ginecologia Oncologica, Fondazione Policlinico Universitario A. Gemelli, Rome, Italy.

Ann Surg Oncol 2021 Feb 23. Epub 2021 Feb 23.

Dipartimento per la salute della Donna e del Bambino e della Salute Pubblica, UOC Ginecologia Oncologica, IRCCS, Fondazione Policlinico Universitario A. Gemelli, Rome, Italy.

Purpose: The purpose of this study was to assess the prognostic role and the perioperative outcomes of conization performed before radical hysterectomy in early-stage cervical carcinoma.

Methods: This multicenter, retrospective observational cohort study included patients with FIGO 2009 stage IB1 cervical carcinoma treated with radical hysterectomy between June 2004 and June 2019. Patients were divided into two groups according to conization before radical surgery. Read More

Int J Surg Pathol 2021 Feb 22:1066896921990726. Epub 2021 Feb 22.

8784University of California San Diego, San Diego, CA, USA.

When more than one focus of stromal invasion is present in a superficially invasive cervical squamous cell carcinoma (SCC), determination of the tumoral lateral extent/horizontal extension, and hence tumor-nodes-metastases (TNM) staging, can be problematic. In recent years, a diagnostic approach to distinguish multifocal pT1a1 from pT1b cases has gained increased attention. These criteria call for classifying SCC as multifocal when invasive foci are separated by blocks of uninvolved cervical tissues, and/or are located on separated cervical lips in a tumor that is discontinuous, and/or are situated far apart (≥2 mm) from each other. Read More

J Obstet Gynaecol Res 2021 May 21;47(5):1871-1877. Epub 2021 Feb 21.

Department of Obstetrics and Gynecology, National Hospital Organization Saitama Hospital, Saitama, Japan.

Aim: The International Federation of Gynecology and Obstetrics (FIGO) revised the cervical cancer staging system in 2018. This study aims to validate the revised staging system in patients with tumors <2 cm in size who were classified as FIGO 2009 stage IB1.

Methods: We evaluated 62 women with stage IB1 cervical cancer (FIGO 2009) who underwent radical hysterectomy as the initial treatment between November 2004 and August 2018 in our institution. Read More

Diagn Pathol 2021 Feb 19;16(1):13. Epub 2021 Feb 19.

Department of Obstetrics and Gynecology, Affiliated Hospital of Weifang Medical University, No. 2428, Yuhe Road, Weifang, 261042, China.

Background: The consistency of pathologists in the diagnosis of cervical intraepithelial neoplasia (CINs) is not ideal, especially between low- and high-grade squamous intraepithelial lesions (LSIL and HSIL). This study was aimed to explore efficient strategies for the grading of CINs.

Methods: The medical records of patients with high risk human papillomavirus (HR-HPV) infections who had underwent cervical biopsy or conization from April 2018 to April 2019 in Beijing Chao-Yang Hospital were collected and examined. Read More

Diagnostics (Basel) 2021 Jan 29;11(2). Epub 2021 Jan 29.

Department of Obstetrics and Gynecology, University of Fukui, Fukui 910-1193, Japan.

Purpose: To evaluate the diagnostic potential of PET/MRI with F-fluorodeoxyglucose (F-FDG) in cervical cancer based on the revised 2018 International Federation of Gynecology and Obstetrics (FIGO) staging system.

Materials And Methods: Seventy-two patients with biopsy-proven primary cervical cancer underwent pretreatment F-FDG PET/MRI, CT, and pelvic MRI. The diagnostic performance of F-FDG PET/MRI and MRI for assessing extent of the primary tumor and F-FDG PET/MRI and CT for assessing nodal and distant metastases was evaluated by two experienced readers. Read More

PLoS One 2021 11;16(2):e0246902. Epub 2021 Feb 11.

Department of Pathology, Vejle, Lillebaelt Hospital, Vejle, Denmark.

Introduction: Danish women exit cervical cancer screening at age 65 years, but 23% of cervical cancer cases occur beyond this age. In addition, due to gradual implementation of cervical cancer screening, older women are underscreened by today´s standards. A one-time screening with HPV test was therefore offered to Danish women born before 1948. Read More