Full Text Available
Note: Clicking the button above will open the full text document at the original institutional repository in a new window.
The impact of positive margins and crypt involvement in excisional procedures of the cervix on recurrence rates of premalignant diseases of the cervix
BACKGROUND Recurrent disease after cervical excisional procedures has been linked to many factors. We aim to determine if positive margins and crypt involvement increased the rate of recurrence of premalignant disease in patients who had excisional procedures. METHODS In this retrospective review of...
Saved in:
| Main Author: | |
|---|---|
| Other Authors: | |
| Format: | Thesis |
| Language: | English |
| Published: |
Department of Obstetrics and Gynaecology
2021
|
| Subjects: | |
| Tags: |
No Tags, Be the first to tag this record!
|
| _version_ | 1867613181441998848 |
|---|---|
| access_status_str | Open Access |
| author | Addae, Haleema |
| author2 | Adams, Tracey |
| author_browse | Adams, Tracey Addae, Haleema |
| author_facet | Adams, Tracey Addae, Haleema |
| author_sort | Addae, Haleema |
| collection | Thesis |
| description | BACKGROUND Recurrent disease after cervical excisional procedures has been linked to many factors. We aim to determine if positive margins and crypt involvement increased the rate of recurrence of premalignant disease in patients who had excisional procedures. METHODS In this retrospective review of the colposcopy database, patient records and pathology database, women who had cervical excisional procedures at the Groote Schuur Hospital colposcopy clinic in 2010 were followed up until 2015. Recurrence was based on high grade cytology or histology at follow up. Chi-square tests were used to compare recurrence rates. RESULTS Two hundred and seventy women were included in the final analysis. 130 women had CIN 3 and 94 had CIN 2 at the excisional procedure. Eighty five (31.5%) had endo-margin involvement, 46 (17%) had ecto-margin involvement, and 24 (8.9%) had dual margin involvement. Two hundred and thirteen (79.2%) had crypt involvement. Recurrence occurred in 30 (19.4%) of the 155 patients we had follow up data on. Of those that recurred, 19 (P<0.001) had positive endo-margin involvement, 10 (P=0.007) had ecto-margin involvement, 9 (P< <0.001) had dual margin involvement, and 28 (P=0.058) had crypt involvement. 155 women (43%) were lost to follow-up CONCLUSION Positive margins at excisional procedure of the cervix have a statistically significant increased risk of recurrence of pre-malignant disease. There was a trend towards recurrence of disease in those who have crypt involvement. In limited resource setting follow up protocols can be adjusted so that women without margin involvement can be seen at longer intervals. |
| format | Thesis |
| id | oai:open.uct.ac.za:11427/33427 |
| institution | University of Cape Town (South Africa) |
| language | eng |
| last_indexed | 2026-06-10T12:32:03.909Z |
| license_str | Not specified — see source repository |
| provenance_str_mv | Harvested via OAI-PMH from UCTD — University of Cape Town Open Access Repository |
| publishDate | 2021 |
| publishDateRange | 2021 |
| publishDateSort | 2021 |
| publisher | Department of Obstetrics and Gynaecology |
| publisherStr | Department of Obstetrics and Gynaecology |
| record_format | dspace |
| source_str | UCTD — University of Cape Town Open Access Repository |
| spelling | oai:open.uct.ac.za:11427/33427 The impact of positive margins and crypt involvement in excisional procedures of the cervix on recurrence rates of premalignant diseases of the cervix Addae, Haleema Adams, Tracey Obstetrics and Gynaecology BACKGROUND Recurrent disease after cervical excisional procedures has been linked to many factors. We aim to determine if positive margins and crypt involvement increased the rate of recurrence of premalignant disease in patients who had excisional procedures. METHODS In this retrospective review of the colposcopy database, patient records and pathology database, women who had cervical excisional procedures at the Groote Schuur Hospital colposcopy clinic in 2010 were followed up until 2015. Recurrence was based on high grade cytology or histology at follow up. Chi-square tests were used to compare recurrence rates. RESULTS Two hundred and seventy women were included in the final analysis. 130 women had CIN 3 and 94 had CIN 2 at the excisional procedure. Eighty five (31.5%) had endo-margin involvement, 46 (17%) had ecto-margin involvement, and 24 (8.9%) had dual margin involvement. Two hundred and thirteen (79.2%) had crypt involvement. Recurrence occurred in 30 (19.4%) of the 155 patients we had follow up data on. Of those that recurred, 19 (P<0.001) had positive endo-margin involvement, 10 (P=0.007) had ecto-margin involvement, 9 (P< <0.001) had dual margin involvement, and 28 (P=0.058) had crypt involvement. 155 women (43%) were lost to follow-up CONCLUSION Positive margins at excisional procedure of the cervix have a statistically significant increased risk of recurrence of pre-malignant disease. There was a trend towards recurrence of disease in those who have crypt involvement. In limited resource setting follow up protocols can be adjusted so that women without margin involvement can be seen at longer intervals. 2021-07-07T07:42:57Z 2021-07-07T07:42:57Z 2021 2021-07-06T07:33:25Z Master Thesis Masters MMed http://hdl.handle.net/11427/33427 eng application/pdf Department of Obstetrics and Gynaecology Faculty of Health Sciences |
| spellingShingle | Obstetrics and Gynaecology Addae, Haleema The impact of positive margins and crypt involvement in excisional procedures of the cervix on recurrence rates of premalignant diseases of the cervix |
| thesis_degree_str | Master's |
| title | The impact of positive margins and crypt involvement in excisional procedures of the cervix on recurrence rates of premalignant diseases of the cervix |
| title_full | The impact of positive margins and crypt involvement in excisional procedures of the cervix on recurrence rates of premalignant diseases of the cervix |
| title_fullStr | The impact of positive margins and crypt involvement in excisional procedures of the cervix on recurrence rates of premalignant diseases of the cervix |
| title_full_unstemmed | The impact of positive margins and crypt involvement in excisional procedures of the cervix on recurrence rates of premalignant diseases of the cervix |
| title_short | The impact of positive margins and crypt involvement in excisional procedures of the cervix on recurrence rates of premalignant diseases of the cervix |
| title_sort | impact of positive margins and crypt involvement in excisional procedures of the cervix on recurrence rates of premalignant diseases of the cervix |
| topic | Obstetrics and Gynaecology |
| url | http://hdl.handle.net/11427/33427 |
| work_keys_str_mv | AT addaehaleema theimpactofpositivemarginsandcryptinvolvementinexcisionalproceduresofthecervixonrecurrenceratesofpremalignantdiseasesofthecervix AT addaehaleema impactofpositivemarginsandcryptinvolvementinexcisionalproceduresofthecervixonrecurrenceratesofpremalignantdiseasesofthecervix |