TY - JOUR
T1 - Role of cervical cytology in surveillance after radical trachelectomy for cervical cancer
AU - Brown, Alaina J.
AU - Shah, Jaimin S.
AU - Fleming, Nicole D.
AU - Nick, Alpa M.
AU - Soliman, Pamela T.
AU - Chisholm, Gary B.
AU - Schmeler, Kathleen M.
AU - Ramirez, Pedro T.
AU - Frumovitz, Michael
N1 - Publisher Copyright:
© 2016 Elsevier Inc.
PY - 2016/8/1
Y1 - 2016/8/1
N2 - Objective There are currently no standard guidelines on the use of Papanicolaou (Pap) tests for surveillance after radical trachelectomy for cervical cancer. The goal of this study was to determine the usefulness of Pap tests in routine surveillance after radical trachelectomy for cervical cancer. Methods Cervical cancer patients who underwent radical trachelectomy from January 2004 through October 2015 and subsequently had at least one Pap test were retrospectively identified. Demographic and clinical characteristics were described and compared between patients with and without at least one abnormal Pap test. The Kaplan-Meier method was used to estimate time to first abnormal Pap test. Results Forty-one patients met inclusion criteria. Of these, 30 (73%) had at least one year in which more than one Pap test per year was obtained. Twenty-four (59%) had at least one abnormal Pap test. Of 238 total Pap tests collected, 44 (18%) were abnormal. The most common abnormality was ASCUS (52%, n = 23). Other findings included LSIL (20%, n = 9), HSIL (2%, n = 1), and AGUS (25%, n = 11). Median time from radical trachelectomy to first abnormal Pap test was 17.2 months (range, 11.8–86.3). No patient had disease recurrence. Surgery type (laparoscopic, open, or robotic), trachelectomy specimen size, histology, device for stenosis prevention (pediatric Foley catheter or Smit Sleeve), and cerclage placement were not significant predictors of an abnormal Pap test. Conclusions The rate of abnormal Pap tests after radical trachelectomy is high; however, the clinical significance of such abnormalities appears limited. The routine use of cervical cytology as surveillance after radical trachelectomy does not appear to substantially impact management decisions.
AB - Objective There are currently no standard guidelines on the use of Papanicolaou (Pap) tests for surveillance after radical trachelectomy for cervical cancer. The goal of this study was to determine the usefulness of Pap tests in routine surveillance after radical trachelectomy for cervical cancer. Methods Cervical cancer patients who underwent radical trachelectomy from January 2004 through October 2015 and subsequently had at least one Pap test were retrospectively identified. Demographic and clinical characteristics were described and compared between patients with and without at least one abnormal Pap test. The Kaplan-Meier method was used to estimate time to first abnormal Pap test. Results Forty-one patients met inclusion criteria. Of these, 30 (73%) had at least one year in which more than one Pap test per year was obtained. Twenty-four (59%) had at least one abnormal Pap test. Of 238 total Pap tests collected, 44 (18%) were abnormal. The most common abnormality was ASCUS (52%, n = 23). Other findings included LSIL (20%, n = 9), HSIL (2%, n = 1), and AGUS (25%, n = 11). Median time from radical trachelectomy to first abnormal Pap test was 17.2 months (range, 11.8–86.3). No patient had disease recurrence. Surgery type (laparoscopic, open, or robotic), trachelectomy specimen size, histology, device for stenosis prevention (pediatric Foley catheter or Smit Sleeve), and cerclage placement were not significant predictors of an abnormal Pap test. Conclusions The rate of abnormal Pap tests after radical trachelectomy is high; however, the clinical significance of such abnormalities appears limited. The routine use of cervical cytology as surveillance after radical trachelectomy does not appear to substantially impact management decisions.
KW - Pap test
KW - Radical trachelectomy
KW - Surveillance
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U2 - 10.1016/j.ygyno.2016.05.030
DO - 10.1016/j.ygyno.2016.05.030
M3 - Article
C2 - 27246304
AN - SCOPUS:84971667796
SN - 0090-8258
VL - 142
SP - 283
EP - 285
JO - Gynecologic oncology
JF - Gynecologic oncology
IS - 2
ER -