Postradical vaginal trachelectomy follow-up by isthmic-vaginal smear cytology: a 13-year audit.
Radical trachelectomy is a fertility preserving alternative for early cervical cancer patients. This audit assesses the role of isthmic-vaginal smear in postoperative follow-up. A total of 94 patients were identified generating 913 smears. The final surgical margin was at the lower uterine segment in 37 cases (39.4%) and significantly correlated with the presence of lower uterine segment endometrial cells (LUSEC) in smears (P = 0.035). The most common abnormal diagnoses in the presence of LUSEC were ASC-US and AGUS seen in 14.2% and 11.9% of positive smears, respectively. The most common follow-up pattern was initial positive smears, which converted to negative (45.7% of patients), showing that reactive changes are another potential overcall pitfall. The only 2 central recurrences were successfully diagnosed by smears. This study summarizes our experience, emphasizing the role of isthmic-vaginal smears for early detection of central recurrence and highlighting the role of LUSEC and reactive changes as potential overcall pitfalls.
Ghorab
Zeina
Z
Department of Pathology, Sunnybrook Health Sciences Center, Toronto, Ontario, Canada M4N 3M5.
Ismiil
Nadia
N
Covens
Allan
A
Nofech-Mozes
Sharon
S
Saad
Reda S
RS
Dubé
Valérie
V
Khalifa
Mahmoud A
MA
D000293:Adolescent; D000328:Adult; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000379:methods*; D006801:Humans; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis*; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000601:surgery*; D014621:Vagina / Q000601:surgery*; D014626:Vaginal Smears / Q000379:methods*; D055815:Young Adult