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The role of cytological follow‐up after radical vaginal trachelectomy for early‐stage cervical cancer
Author(s) -
Edey K.,
Denton K.,
Murdoch J.
Publication year - 2014
Publication title -
cytopathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.512
H-Index - 48
eISSN - 1365-2303
pISSN - 0956-5507
DOI - 10.1111/cyt.12066
Subject(s) - trachelectomy , cytology , medicine , cytopathology , gynecology , stage (stratigraphy) , cervical cancer , retrospective cohort study , cancer , obstetrics , pathology , paleontology , biology
Objectives To identify whether recurrences were picked up by cytology alone after radical vaginal trachelectomy and to determine the false‐positive rate of abnormal cytology. Methods Retrospective collection of patients from the cancer registry since radical vaginal trachelectomy was first performed in Bristol in 1999. All cytology results were collated and re‐reviewed by a senior consultant cellular pathologist at the cytopathology centre in S outhmead H ospital, B ristol. Cytology results and pathology and survival data are discussed, and any downgrading or upgrading of reports is reviewed. Results Eighteen women were identified and 80 isthmic cytology samples were reviewed. Only one recurrence has occurred. Lower uterine segment sampling was apparent in 25 samples and other endometrial cells in 21 samples: thus 58% showed endometrial cell sampling. Odd metaplastic cells from the newly formed transformation zone were found in 25 samples (31%). Fifteen (19%) showed significant inflammation, two with actinomyces. After cytology review, seven of 80 reports were changed: two between negative and inadequate, two borderline changes in endocervical cells and one mild dyskaryosis were downgraded to negative, and two cases reported as ?glandular neoplasia were changed to squamous cell carcinoma and negative, respectively. Conclusions Cytology reporting may be challenging after trachelectomy. Cytology in our series did not add to the diagnosis of recurrence in the one case in which it occurred. We propose a pragmatic follow‐up regime, and discuss the importance of the centralization of cytology reporting in these patients.