Imperial College London
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Professor Maria Kyrgiou

Faculty of Medicine, Department of Metabolism, Digestion and Reproduction

Chair in Gynaecologic Oncology
 
 
 
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Contact

 

+44 (0)20 7594 2177m.kyrgiou Website

 
 
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Location

 

Institute of Reproductive and Developmental BiologyHammersmith Campus

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Summary

 

Publications

Citation

BibTex format

@article{Arbyn:2017:10.1016/S1470-2045(17)30700-3,
author = {Arbyn, M and Redman, CWE and Verdoodt, F and Kyrgiou, M and Tzafetas, M and Ghaem-Maghami, S and Petry, K-U and Leeson, S and Bergeron, C and Nieminen, P and Gondry, J and Reich, O and Moss, EL},
doi = {10.1016/S1470-2045(17)30700-3},
journal = {Lancet Oncology},
pages = {1665--1679},
title = {Incomplete excision of cervical precancer as a predictor of treatment failure: a systematic review and meta-analysis},
url = {http://dx.doi.org/10.1016/S1470-2045(17)30700-3},
volume = {18},
year = {2017}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - BACKGROUND: Incomplete excision of cervical precancer is associated with therapeutic failure and is therefore considered as a quality indicator of clinical practice. Conversely, the risk of preterm birth is reported to correlate with size of cervical excision and therefore balancing the risk of adequate treatment with iatrogenic harm is challenging. We reviewed the literature with an aim to reveal whether incomplete excision, reflected by presence of precancerous tissue at the section margins, or post-treatment HPV testing are accurate predictors of treatment failure. METHODS: We did a systematic review and meta-analysis to assess the risk of therapeutic failure associated with the histological status of the margins of the tissue excised to treat cervical precancer. We estimated the accuracy of the margin status to predict occurrence of residual or recurrent high-grade cervical intraepithelial neoplasia of grade two or worse (CIN2+) and compared it with post-treatment high-risk human papillomavirus (HPV) testing. We searched for published systematic reviews and new references from PubMed-MEDLINE, Embase, and CENTRAL and did also a new search spanning the period Jan 1, 1975, until Feb 1, 2016. Studies were eligible if women underwent treatment by excision of a histologically confirmed CIN2+ lesion, with verification of presence or absence of CIN at the resection margins; were tested by cytology or HPV assay between 3 months and 9 months after treatment; and had subsequent follow-up of at least 18 months post-treatment including histological confirmation of the occurrence of CIN2+. Primary endpoints were the proportion of positive section margins and the occurrence of treatment failure associated with the marginal status, in which treatment failure was defined as occurrence of residual or recurrent CIN2+. Information about positive resection margins and subsequent treatment failure was pooled using procedures for meta-analysis of binomial data and analysed using rando
AU  - Arbyn,M
AU  - Redman,CWE
AU  - Verdoodt,F
AU  - Kyrgiou,M
AU  - Tzafetas,M
AU  - Ghaem-Maghami,S
AU  - Petry,K-U
AU  - Leeson,S
AU  - Bergeron,C
AU  - Nieminen,P
AU  - Gondry,J
AU  - Reich,O
AU  - Moss,EL
DO  - 10.1016/S1470-2045(17)30700-3
EP  - 1679
PY  - 2017///
SN  - 1470-2045
SP  - 1665
TI  - Incomplete excision of cervical precancer as a predictor of treatment failure: a systematic review and meta-analysis
T2  - Lancet Oncology
UR  - http://dx.doi.org/10.1016/S1470-2045(17)30700-3
UR  - https://www.sciencedirect.com/science/article/pii/S1470204517307003?via%3Dihub
UR  - http://hdl.handle.net/10044/1/53953
VL  - 18
ER  -
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