Evidence map›Paper›PMID 33962590›Full record

ArticleBMC women's health2021

Necessity for subsequent surgery in women of child-bearing age with positive margins after conization.

Xinmei Wang, Juan Xu, Yang Gao, Pengpeng Qu

Erratum issuedOpen access · goldAbstract read
In one paragraph

Article in BMC women's health, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
1.4field-weighted citation impact, top 19% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 13 citations in OpenAlex.

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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

4 authors at 2 institutions in 1 country.

Xinmei WangClinical College of Central Gynecology and Obstetrics, Tianjin Medical University, Tianjin, 300070, China.ORCID http://orcid.org/0000-0002-2874-0946
Juan XuClinical College of Central Gynecology and Obstetrics, Tianjin Medical University, Tianjin, 300070, China.
Yang GaoClinical College of Central Gynecology and Obstetrics, Tianjin Medical University, Tianjin, 300070, China.
Pengpeng QuDepartment of Gynecological Oncology, Tianjin Central Hospital of Gynecology and Obstetrics, Tianjin, 300100, China. qu.pengpeng@hotmail.com.
Tianjin Central Hospital of Gynecology Obstetrics · CNTianjin Medical University · CN

Funding

Establishment and clinical application of early diagnosis system for cervical precancerous lesions caused by HPV E6 and E7 19YFZCSY00600
6 · The paper itself

Abstract

background20-25% 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. A design for postoperative management and avoidance of overtreatment needs to be provided, especially for women of child-bearing age.

methodsThis study was a retrospective analysis of 1309 women of child-bearing age with HSIL, who underwent cold knife conization (CKC). Age, gravidity, parity, human papillomavirus (HPV) species, cytology, transformation zone type, results of endocervical curettage (ECC), quadrant involvement, glandular involvement, and Cervical Intraepithelial Neoplasia (CIN) grade were analyzed. Among those with positive margins, 245 patients underwent secondary surgery within three months, including CKC, a loop electrosurgical excision procedure, and total hysterectomy. Risk factors for positive margins and residual lesions were assessed.

resultsThere was no significant difference in age, gravidity, parity, glandular involvement, and CIN grade between the two groups (P > 0.3). There was a significant difference in HPV species, cytology, ECC results, and quadrant involvement (P < 0.002). Multivariate analysis showed a major cytology abnormality, high-risk HPV infection, type III transformation zone, positive ECC result, and multiple quadrant involvement were independent risk factors for positive margins and residual lesions (P < 0.02). Age > 35 years was also a risk factor for residual lesions (P < 0.03).

conclusionHigh-risk women should be treated appropriately considering fertility. Patients with positive margins should be managed uniquely. Surgery for women without fertility may be appropriate. Close follow-up is necessary for women who have fertility requirements or are unwilling to undergo subsequent surgery if they have no risk factors, especially women < 35 years.

Indexed as

Uterine Cervical DysplasiaUterine Cervical NeoplasmsAdultChildConizationFemaleHumansNeoplasm Recurrence, LocalPregnancyRetrospective StudiesCervical intraepithelial neoplasia (CIN)Cold knife conization (CKC)High-risk HPVPositive marginsResidual lesionsWomen of child-bearing age

Identifiers

PMID33962590
PMCPMC8103630
OpenAlexW3157683624

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.