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T : 목차정보

Journal of gynecologic oncology : jgo 20건

  1. [국내논문]   Peritoneal cancer index as a predictor of survival in advanced stage serous epithelial ovarian cancer: a prospective study   SCIE

    Elzarkaa, Alaa A. (Department of Obstetrics and Gynecology, University of Alexandria, Alexandria, Egypt . ) , Shaalan, Waleed (Department of Obstetrics and Gynecology, University of Alexandria, Alexandria, Egypt . ) , Elemam, Doaa (Department of Public Health and Preventive Medicine, University of Mansura, Mansura, Egypt . ) , Mansour, Hassan (Department of Obstetrics and Gynecology, University of Alexandria, Alexandria, Egypt . ) , Melis, Mahmoud (Department of Obstetrics and Gynecology, University of Alexandria, Alexandria, Egypt . ) , Malik, Eduard (Department of Obstetrics and Gynecology, University Women's Hospital, Klinikum Oldenburg, University of Oldenburg, Oldenburg, Germany . ) , Soliman, Amr A. (Department of Obstetrics and Gynecology, University Women's Hospital, Klinikum Oldenburg, University of Oldenburg, Oldenburg, Germany . )
    Journal of gynecologic oncology : jgo v.29 no.4 ,pp. e47 , 2018 , 2005-0380 ,

    초록

    Objective A numerical score, the peritoneal cancer index (PCI), was developed to reflect the extent of tumor growth in gastric and colorectal cancers and to tailor treatment. This study aimed to examine the value of the PCI score in advanced epithelial ovarian cancer (EOC) regarding completeness of surgical cytoreduction and survival. Methods This was a prospective observational cohort study. Patients with primary serous EOC at International Federation of Gynecology and Obstetrics (FIGO) stages IIIB or higher were included. Patients with FIGO stage IVB as well as those assigned to receive neoadjuvant treatment were excluded from the study. The PCI was obtained and registered intraoperatively. Results In the study period we recruited 96 patients with serous EOC stage IIIB–IVA. A PCI score cut-off value of 13 was calculated using a receiver operator characteristic (ROC) curve, above which worse survival is expected (area under the curve [AUC]=0.641; 95% confidence interval [CI]=0.517–0.765; sensitivity and specificity 80.6%, 45.0%, respectively; p=0.050). A multivariate analysis determined that suboptimal surgical cytoreduction was the only independent predictive factor for recurrence (odds ratio [OR]=7.548; 95% CI=1.473–38.675; p=0.015). A multivariate analysis determined that only suboptimal surgical cytoreduction (hazard ratio [HR]=2.33; 95% CI=0.616–8.795; p=0.005), but not PCI score >13 (HR=1.289; 95% CI=0.329–5.046; p=0.716), was an independent predictive factor for death. Conclusion We conclude from this study that the PCI score is a reliable tool helping to assess the extent of disease in advanced serous EOC patients and may help predicting complete surgical cytoreduction but cannot qualify as a predictor of survival.

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    회원님의 원문열람 권한에 따라 열람이 불가능 할 수 있으며 권한이 없는 경우 해당 사이트의 정책에 따라 회원가입 및 유료구매가 필요할 수 있습니다.이동하는 사이트에서의 모든 정보이용은 NDSL과 무관합니다.

    NDSL에서는 해당 원문을 복사서비스하고 있습니다. 아래의 원문복사신청 또는 장바구니담기를 통하여 원문복사서비스 이용이 가능합니다.

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  2. [국내논문]   The use of conization to identify and treat severe lesions among prediagnosed CIN1 and 2 patients in Japan   SCIE

    Mikami, Mikio (Department of Obstetrics and Gynecology, Tokai University School of Medicine, Isehara, Japan . ) , Ikeda, Masae (Department of Obstetrics and Gynecology, Tokai University School of Medicine, Isehara, Japan . ) , Sato, Hidetaka (Department of Obstetrics and Gynecology, Kitasato University School of Medicine, Sagamihara, Japan . ) , Iwase, Haruko (Department of Obstetrics and Gynecology, Kitasato University School of Medicine, Sagamihara, Japan . ) , Enomoto, Takayuki (Department of Obstetrics and Gynecology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan . ) , Kobayashi, Yoichi (Department of Obstetrics and Gynecology, Kyorin University School of Medicine, Tokyo, Japan . ) , Katabuchi, Hidetaka (Department of Obstetrics and Gynecology, Kumamoto University, Faculty of Life Sciences, Kumamoto, Japan . )
    Journal of gynecologic oncology : jgo v.29 no.4 ,pp. e46 , 2018 , 2005-0380 ,

    초록

    Objective To evaluate the clinical efficiency of identifying patients with suspicious severe lesions by conization among prediagnosed cervical intraepithelial neoplasia (CIN) 1 and 2 patients in Japan. Methods The data in a Japanese nation-wide registry for cervical cancer (2009 and 2011) was collected to analyze the clinical efficacy of pre- and postdiagnosis for 13,215 Japanese women who underwent treatment by conization. Their preoperative and postoperative histologic findings and clinical outcomes were evaluated using standard statistical procedures including clinical and demographic characteristics. Results Almost half of 1,536 women who were treated by conization after the prediagnosis of CIN1 and 2 because the lesions showed no evidence of natural regression actually contained CIN1–2 (45.0%), CIN3 (47%), or invasive cancer (2.7%) in their cervical tissue. They underwent conization either for therapeutic (treatment) (78.5%) or diagnostic (21.5%) reasons. Invasive disease was diagnosed postoperatively more often in diagnostic cases (6.1%) than in therapeutic cases (2.8%). All the patients survived their diagnostic and therapeutic conization after approximately 30 months of follow up. Conclusion Our study shows that the continuous observation of the prediagnosed CIN1 and 2 cases by the combination of cytology, colposcopy and histology in Japan has worked successfully to identify severe lesions by using conization as well in the process.

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    무료다운로드 유료다운로드

    회원님의 원문열람 권한에 따라 열람이 불가능 할 수 있으며 권한이 없는 경우 해당 사이트의 정책에 따라 회원가입 및 유료구매가 필요할 수 있습니다.이동하는 사이트에서의 모든 정보이용은 NDSL과 무관합니다.

    NDSL에서는 해당 원문을 복사서비스하고 있습니다. 아래의 원문복사신청 또는 장바구니담기를 통하여 원문복사서비스 이용이 가능합니다.

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  3. [국내논문]   Quality of tissue from punch biopsy forceps vs. round loop electrode in colposcopically directed biopsy: a randomized controlled trial  

    Wetcho, Thanita (Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand. ) , Rattanaburi, Athithan (Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand. ) , Kanjanapradit, Kanet (Department of Pathology, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand.)
    Journal of gynecologic oncology : jgo v.29 no.4 , 2018 , 2005-0380 ,

    초록

    Objective To evaluate the clinical efficiency of identifying patients with suspicious severe lesions by conization among prediagnosed cervical intraepithelial neoplasia (CIN) 1 and 2 patients in Japan. Methods The data in a Japanese nation-wide registry for cervical cancer (2009 and 2011) was collected to analyze the clinical efficacy of pre- and postdiagnosis for 13,215 Japanese women who underwent treatment by conization. Their preoperative and postoperative histologic findings and clinical outcomes were evaluated using standard statistical procedures including clinical and demographic characteristics. Results Almost half of 1,536 women who were treated by conization after the prediagnosis of CIN1 and 2 because the lesions showed no evidence of natural regression actually contained CIN1–2 (45.0%), CIN3 (47%), or invasive cancer (2.7%) in their cervical tissue. They underwent conization either for therapeutic (treatment) (78.5%) or diagnostic (21.5%) reasons. Invasive disease was diagnosed postoperatively more often in diagnostic cases (6.1%) than in therapeutic cases (2.8%). All the patients survived their diagnostic and therapeutic conization after approximately 30 months of follow up. Conclusion Our study shows that the continuous observation of the prediagnosed CIN1 and 2 cases by the combination of cytology, colposcopy and histology in Japan has worked successfully to identify severe lesions by using conization as well in the process.

    원문보기

    원문보기
    무료다운로드 유료다운로드

    회원님의 원문열람 권한에 따라 열람이 불가능 할 수 있으며 권한이 없는 경우 해당 사이트의 정책에 따라 회원가입 및 유료구매가 필요할 수 있습니다.이동하는 사이트에서의 모든 정보이용은 NDSL과 무관합니다.

    NDSL에서는 해당 원문을 복사서비스하고 있습니다. 아래의 원문복사신청 또는 장바구니담기를 통하여 원문복사서비스 이용이 가능합니다.

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    Fig. 1 이미지
  4. [국내논문]   Predicting factors for resumption of spontaneous voiding following nerve-sparing radical hysterectomy   SCIE

    Nantasupha, Chalaithorn (Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand . ) , Charoenkwan, Kittipat (Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand . )
    Journal of gynecologic oncology : jgo v.29 no.4 ,pp. e59 , 2018 , 2005-0380 ,

    초록

    Objective To determine factors affecting voiding recovery on the day of Foley catheter removal (postoperative day 7, POD7) after nerve-sparing radical hysterectomy (NSRH) for early-stage cervical cancer. Methods Early-stage cervical cancer patients, who underwent type C1 radical hysterectomy between January 2006 and June 2016 were included. Clinical and pathological data were reviewed. Association between inability to attain adequate voiding function on POD7 and potential predicting factors were evaluated in univariate and multivariate analysis. Results Of 755 patients, 383 (50.7%) resumed adequate voiding function on POD7 while 372 (49.3%) did not. Tumor size was larger in patients whose voiding function was inadequate (2.5 vs. 2.0 cm, p=0.001). Lengths of resected parametria and adjacent vagina were more extensive in patients with inadequate voiding function (p 4 cm (p 4 cm, postoperative urinary tract infection, and primary surgeon were significantly associated with inability to attain adequate voiding function on POD7. Conclusion Extent of disease represented by tumor size, urinary tract infection as well as individual surgeon's technique independently predict resumption of adequate voiding function on POD7 following NSRH.

    원문보기

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    무료다운로드 유료다운로드

    회원님의 원문열람 권한에 따라 열람이 불가능 할 수 있으며 권한이 없는 경우 해당 사이트의 정책에 따라 회원가입 및 유료구매가 필요할 수 있습니다.이동하는 사이트에서의 모든 정보이용은 NDSL과 무관합니다.

    NDSL에서는 해당 원문을 복사서비스하고 있습니다. 아래의 원문복사신청 또는 장바구니담기를 통하여 원문복사서비스 이용이 가능합니다.

    이미지

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  5. [국내논문]   Are patients and physicians willing to accept less-radical procedures for cervical cancer?   SCIE

    Gungorduk, Kemal (Department of Gynecologic Oncology, Muğla Sıtkı Koçman University, Education and Research Hospital, Muğla, Turkey . ) , Kocian, Roman (Department of Obstetrics and Gynecology, Gynecologic Oncology Center, First Faculty of Medicine, Charles University, Prague, Czech Republic . ) , Basaran, Derman (Department of Gynecologic Oncology, Etlik Zübeyde Hanım Education and Research Hospital, Ankara, Turkey . ) , Turan, Taner (Department of Gynecologic Oncology, Etlik Zübeyde Hanım Education and Research Hospital, Ankara, Turkey . ) , Ozdemir, Aykut (Department of Gynecologic Oncology, Muğla Sıtkı Koçman University, Education and Research Hospital, Muğla, Turkey . ) , Cibula, David (Department of Obstetrics and Gynecology, Gynecologic Oncology Center, First Faculty of Medicine, Charles University, Prague, Czech Republic . )
    Journal of gynecologic oncology : jgo v.29 no.4 ,pp. e50 , 2018 , 2005-0380 ,

    초록

    Objective To evaluate the opinions of women who underwent surgery for cervical cancer (CC) and physicians who treat CC about the acceptability of increased oncological risk after less-radical surgery. Methods One hundred eighty-two women who underwent surgery for CC and 101 physicians participated in a structured survey in 3 tertiary cancer centers in Czech Republic and Turkey. Patients and physicians were asked whether they would accept any additional oncological risks, which would be attributable to the omission of parametrectomy (radical hysterectomy/trachelectomy vs. simple hysterectomy/trachelectomy) or pelvic lymph node dissection (systematic resection vs. sentinel lymph node sampling). Results Although 52.2% of patients reported morbidity related to their previous treatment, the majority of patients would not accept less-radical surgical treatment if it was associated with any increased risk of recurrence (50%–55%, no risk; 17%–24%, risk Conclusion Patients, even if they suffered from morbidity related to previous CC treatment, do not want to choose between oncological safety and a better quality of life. Physicians tend to accept the higher oncological risk associated with less-radical surgical procedures, but attitudes differ regionally. Professionals should be aware of this tendency when counselling the patients before less-radical surgery.

    원문보기

    원문보기
    무료다운로드 유료다운로드

    회원님의 원문열람 권한에 따라 열람이 불가능 할 수 있으며 권한이 없는 경우 해당 사이트의 정책에 따라 회원가입 및 유료구매가 필요할 수 있습니다.이동하는 사이트에서의 모든 정보이용은 NDSL과 무관합니다.

    NDSL에서는 해당 원문을 복사서비스하고 있습니다. 아래의 원문복사신청 또는 장바구니담기를 통하여 원문복사서비스 이용이 가능합니다.

    이미지

    Fig. 1 이미지
  6. [국내논문]   Minimally invasive surgery for cervical cancer: consequences for treatment after LACC Study   SCIE

    Kimmig, Rainer (Department of Obstetrics and Gynaecology, West German Cancer Center, University Hospital of Essen, Essen, Germany . ) , Ind, Thomas (Department of Gynaecological Oncology, Royal Marsden Hospital, London, UK . )
    Journal of gynecologic oncology : jgo v.29 no.4 ,pp. e75 , 2018 , 2005-0380 ,

    초록

    Objective To evaluate the opinions of women who underwent surgery for cervical cancer (CC) and physicians who treat CC about the acceptability of increased oncological risk after less-radical surgery. Methods One hundred eighty-two women who underwent surgery for CC and 101 physicians participated in a structured survey in 3 tertiary cancer centers in Czech Republic and Turkey. Patients and physicians were asked whether they would accept any additional oncological risks, which would be attributable to the omission of parametrectomy (radical hysterectomy/trachelectomy vs. simple hysterectomy/trachelectomy) or pelvic lymph node dissection (systematic resection vs. sentinel lymph node sampling). Results Although 52.2% of patients reported morbidity related to their previous treatment, the majority of patients would not accept less-radical surgical treatment if it was associated with any increased risk of recurrence (50%–55%, no risk; 17%–24%, risk Conclusion Patients, even if they suffered from morbidity related to previous CC treatment, do not want to choose between oncological safety and a better quality of life. Physicians tend to accept the higher oncological risk associated with less-radical surgical procedures, but attitudes differ regionally. Professionals should be aware of this tendency when counselling the patients before less-radical surgery.

    원문보기

    원문보기
    무료다운로드 유료다운로드

    회원님의 원문열람 권한에 따라 열람이 불가능 할 수 있으며 권한이 없는 경우 해당 사이트의 정책에 따라 회원가입 및 유료구매가 필요할 수 있습니다.이동하는 사이트에서의 모든 정보이용은 NDSL과 무관합니다.

    NDSL에서는 해당 원문을 복사서비스하고 있습니다. 아래의 원문복사신청 또는 장바구니담기를 통하여 원문복사서비스 이용이 가능합니다.

    이미지

    Fig. 1 이미지
  7. [국내논문]   Hyperthermic intraperitoneal chemotherapy in advanced ovarian cancer   SCIE

    Wu, Tao (Department of Gynecologic Cancer, Shaanxi Provincial Tumor Hospital, Xian, China . ) , Zhao, Xi-Xia (Department of Gynecologic Cancer, Shaanxi Provincial Tumor Hospital, Xian, China . ) , Wang, Guo-Qing (Department of Gynecologic Cancer, Shaanxi Provincial Tumor Hospital, Xian, China . )
    Journal of gynecologic oncology : jgo v.29 no.4 ,pp. e51 , 2018 , 2005-0380 ,

    초록

    Objective To evaluate the opinions of women who underwent surgery for cervical cancer (CC) and physicians who treat CC about the acceptability of increased oncological risk after less-radical surgery. Methods One hundred eighty-two women who underwent surgery for CC and 101 physicians participated in a structured survey in 3 tertiary cancer centers in Czech Republic and Turkey. Patients and physicians were asked whether they would accept any additional oncological risks, which would be attributable to the omission of parametrectomy (radical hysterectomy/trachelectomy vs. simple hysterectomy/trachelectomy) or pelvic lymph node dissection (systematic resection vs. sentinel lymph node sampling). Results Although 52.2% of patients reported morbidity related to their previous treatment, the majority of patients would not accept less-radical surgical treatment if it was associated with any increased risk of recurrence (50%–55%, no risk; 17%–24%, risk Conclusion Patients, even if they suffered from morbidity related to previous CC treatment, do not want to choose between oncological safety and a better quality of life. Physicians tend to accept the higher oncological risk associated with less-radical surgical procedures, but attitudes differ regionally. Professionals should be aware of this tendency when counselling the patients before less-radical surgery.

    원문보기

    원문보기
    무료다운로드 유료다운로드

    회원님의 원문열람 권한에 따라 열람이 불가능 할 수 있으며 권한이 없는 경우 해당 사이트의 정책에 따라 회원가입 및 유료구매가 필요할 수 있습니다.이동하는 사이트에서의 모든 정보이용은 NDSL과 무관합니다.

    NDSL에서는 해당 원문을 복사서비스하고 있습니다. 아래의 원문복사신청 또는 장바구니담기를 통하여 원문복사서비스 이용이 가능합니다.

    이미지

    Fig. 1 이미지
  8. [국내논문]   Risks of cervical intraepithelial neoplasia grade 3 or invasive cancers in ASCUS women with different management: a population-based cohort study   SCIE

    Tai, Yi-Jou (Department of Obstetrics and Gynecology, College of Medicine, National Taiwan University, Taipei, Taiwan . ) , Chen, Yun-Yuan (Department of Obstetrics and Gynecology, College of Medicine, National Taiwan University, Taipei, Taiwan . ) , Hsu, Huang-Cheng (Department of Obstetrics and Gynecology, College of Medicine, National Taiwan University, Taipei, Taiwan . ) , Chiang, Chun-Ju (Graduate Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan . ) , You, San-Lin (Department of Public Health, College of Medicine and Big Data Research Centre, Fu-Jen Catholic University, New Taipei City, Taiwan . ) , Chen, Chi-An (Department of Obstetrics and Gynecology, College of Medicine, National Taiwan University, Taipei, Taiwan . ) , Cheng, Wen-Fang (Department of Obstetrics and Gynecology, College of Medicine, National Taiwan University, Taipei, Taiwan . )
    Journal of gynecologic oncology : jgo v.29 no.4 ,pp. e55 , 2018 , 2005-0380 ,

    초록

    Objective To investigate the progression risk of atypical squamous cells of undetermined significance (ASCUS) with different clinical managements. Methods Women with their first diagnosis of ASCUS cytology were retrieved from the national cervical cancer screening database and linked to the national health insurance research database to identify the management of these women. The incidences of developing cervical intraepithelial neoplasia grade 3 and invasive cervical cancer (CIN3+) were calculated, and the hazard ratios (HRs) were estimated using a Cox proportional hazards model. This study was approved by the Research Ethics Committee of the National Taiwan University Hospital and is registered at ClinicalTrials.gov (Identifier: NCT02063152). Results There were total 69,741 women included. Various management strategies including colposcopy, cervical biopsies and/or endocervical curettage, and cryotherapy, failed to reduce the risk of subsequent CIN3+ compared with repeat cervical smears. Loop electrosurgical excision procedure/conization significantly decreased risk of subsequent CIN3+ lesions (HR=0.22; 95% confidence interval [CI]=0.07–0.68; p=0.010). Women in their 40s–50s had an approximately 30% risk reduction compared to other age groups. Women with a previous screening history >5 years from the present ASCUS diagnosis were at increased risk for CIN3+ (HR=1.24; 95% CI=1.03–1.49; p=0.020). Conclusion In women of first-time ASCUS cytology, a program of repeat cytology can be an acceptable clinical option in low-resource settings. Caution should be taken especially in women with remote cervical screening history more than 5 years.

    원문보기

    원문보기
    무료다운로드 유료다운로드

    회원님의 원문열람 권한에 따라 열람이 불가능 할 수 있으며 권한이 없는 경우 해당 사이트의 정책에 따라 회원가입 및 유료구매가 필요할 수 있습니다.이동하는 사이트에서의 모든 정보이용은 NDSL과 무관합니다.

    NDSL에서는 해당 원문을 복사서비스하고 있습니다. 아래의 원문복사신청 또는 장바구니담기를 통하여 원문복사서비스 이용이 가능합니다.

    이미지

    Fig. 1 이미지
  9. [국내논문]   Survival impact of low anterior resection in patients with epithelial ovarian cancer grossly confined to the pelvic cavity: a Korean multicenter study  

    Kim, Miseon (Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seongnam, Korea. ) , Suh, Dong Hoon (Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seongnam, Korea. ) , Park, Jeong-Yeol (Department of Obstetrics and Gynecology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea. ) , Paik, E Sun (Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. ) , Lee, Seungmee (Department of Obstetrics and Gynecology, Seoul National University Hospital, Seoul, Korea. ) , Eoh, Kyung Jin (Department of Obstetrics and Gynecology, Yonsei University College of Medicine, Seoul, Korea. ) , Nam, Joo-Hyun (Department of Obstetrics and Gynecology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea. ) , Lee, Yoo-Young (Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. ) , Kim, Jae-Weon (Department of Obstetrics and Gynecology, Seoul National University Hospital, Seoul, Korea. ) , Kim, Sunghoon (Department of Obstetri)
    Journal of gynecologic oncology : jgo v.29 no.4 , 2018 , 2005-0380 ,

    초록

    Objective To investigate the progression risk of atypical squamous cells of undetermined significance (ASCUS) with different clinical managements. Methods Women with their first diagnosis of ASCUS cytology were retrieved from the national cervical cancer screening database and linked to the national health insurance research database to identify the management of these women. The incidences of developing cervical intraepithelial neoplasia grade 3 and invasive cervical cancer (CIN3+) were calculated, and the hazard ratios (HRs) were estimated using a Cox proportional hazards model. This study was approved by the Research Ethics Committee of the National Taiwan University Hospital and is registered at ClinicalTrials.gov (Identifier: NCT02063152). Results There were total 69,741 women included. Various management strategies including colposcopy, cervical biopsies and/or endocervical curettage, and cryotherapy, failed to reduce the risk of subsequent CIN3+ compared with repeat cervical smears. Loop electrosurgical excision procedure/conization significantly decreased risk of subsequent CIN3+ lesions (HR=0.22; 95% confidence interval [CI]=0.07–0.68; p=0.010). Women in their 40s–50s had an approximately 30% risk reduction compared to other age groups. Women with a previous screening history >5 years from the present ASCUS diagnosis were at increased risk for CIN3+ (HR=1.24; 95% CI=1.03–1.49; p=0.020). Conclusion In women of first-time ASCUS cytology, a program of repeat cytology can be an acceptable clinical option in low-resource settings. Caution should be taken especially in women with remote cervical screening history more than 5 years.

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  10. [국내논문]   Rethinking surgical concepts for early cervical cancer   SCIE

    Seol, Hyun-Joo (Department of Obstetrics and Gynecology, Kyung Hee University Hospital at Gangdong, School of Medicine, Kyung Hee University, Seoul, Korea . ) , Lee, Jong-Min (Department of Obstetrics and Gynecology, Kyung Hee University Hospital at Gangdong, School of Medicine, Kyung Hee University, Seoul, Korea . )
    Journal of gynecologic oncology : jgo v.29 no.4 ,pp. e58 , 2018 , 2005-0380 ,

    초록

    Objective To investigate the progression risk of atypical squamous cells of undetermined significance (ASCUS) with different clinical managements. Methods Women with their first diagnosis of ASCUS cytology were retrieved from the national cervical cancer screening database and linked to the national health insurance research database to identify the management of these women. The incidences of developing cervical intraepithelial neoplasia grade 3 and invasive cervical cancer (CIN3+) were calculated, and the hazard ratios (HRs) were estimated using a Cox proportional hazards model. This study was approved by the Research Ethics Committee of the National Taiwan University Hospital and is registered at ClinicalTrials.gov (Identifier: NCT02063152). Results There were total 69,741 women included. Various management strategies including colposcopy, cervical biopsies and/or endocervical curettage, and cryotherapy, failed to reduce the risk of subsequent CIN3+ compared with repeat cervical smears. Loop electrosurgical excision procedure/conization significantly decreased risk of subsequent CIN3+ lesions (HR=0.22; 95% confidence interval [CI]=0.07–0.68; p=0.010). Women in their 40s–50s had an approximately 30% risk reduction compared to other age groups. Women with a previous screening history >5 years from the present ASCUS diagnosis were at increased risk for CIN3+ (HR=1.24; 95% CI=1.03–1.49; p=0.020). Conclusion In women of first-time ASCUS cytology, a program of repeat cytology can be an acceptable clinical option in low-resource settings. Caution should be taken especially in women with remote cervical screening history more than 5 years.

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