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M321 CERVICAL IN-SITU SQUAMOUS CELL CARCINOMA AND PREGNANCY
S634
Poster presentations / International Journal of Gynecology & Obstetrics 119S3 (2012) S531–S867
influence the pregnancy of patients with borderline or malignant ovarian neoplasms and conservative treatment. Once pregnant, they are in high risk for perinatal complications, abortion, premature delivery and recurrence especially, and would be prudent to seek specialized perinatal care. M318 MEIGS’ SYNDROME: CASE REPORT O. Gliozheni1 , E. Kallfa1 , K. Kati1 , E. Ndoni1 . 1 Gynecology, UHOG ‘Koco Gliozheni’, Tirana, Albania Meigs’ syndrome consists of a benign ovarian tumor accompanied by ascites and hydrothorax. Elevated serum carbohydrate antigen 125 (CA-125) levels in postmenopausal women with solid adnexal masses, ascites and pleural effusion are highly suggestive for malignant ovarian tumor. However, patients with Meigs’ syndrome can also have elevated serum CA 125 levels. We are presenting a case of Meigs’ syndrome due to right ovary, with elevated CA 125. M319 COLPOSCOPY IN POSTMENOPAUSAL WOMEN: A NINE YEAR REVIEW E. Moore1 , S. Kumar1 , R. Joseph1 , S. Phadnis1 , M. Padwick1 , A. Sanusi1 . 1 Watford General Hospital, Watford, United Kingdom Objectives: To determine the prevalence of cervical intraepithelial neoplasia (CIN) in women over the age of fifty and study the correlation between cytology and colposcopy. Materials: All women over the age of fifty years attending our colposcopy clinic between 1st January 2002 and 31st December 2011 were identified using the Cyres database. Methods: The primary outcome measure was histology of cervical biopsy. Results: During the study period 3700 women were referred. Histology results for 1216 (33%) women were available. 316/1216 (26%) women had CIN1, 236/1216 (19%) CIN2–3 and 20/1216 (2%) cancer. Of the women diagnosed with cancer two were refereed with borderline or negative smears. The remaining 18 women were referred with severe or suspected glandular abnormalities on cytology, or as an urgent clinical referral. Of the 236 women with CIN2–3, 107/236 (45%) women were referred with negative, borderline or mild dyskaryosis on cytology. 59/107 (55%) were thought to be normal or low grade at colposcopy with 54 (92%) having a satisfactory colposcopy. Of the women with CIN1 31/316 (10%) were referred with moderate or severe smears. Of these 13/31 (42%) were thought to be high grade at colposcopy with 10 (77%) having a satisfactory colposcopy. Conclusions: In our cohort of women over fifty years, there is poor correlation between referral smear and histology. M320 FIVE YEAR FOLLOW UP FOR WOMEN WITH INCOMPLETE ENDOCERVICAL MARGIN FOLLOWING LLETZ S. Kumar1 , R. Joseph1 , E. Moore1 , S. Phadnis1 , M. Padwick1 , A. Sanusi1 . 1 Watford General Hospital, Watford, United Kingdom Objectives: We aim to study the recurrence rate following treatment for high-grade CIN, when residual CIN was present at the endocervical margin of the index specimen. Materials: We performed a cohort study of women who had excisional treatment for high-grade CIN between 1st January 2001 and 31st December 2006. Subjects with LLETZ specimens showing CIN at the endocervical margin were included. Methods: The primary outcome measure was the grade of smear at follow-up post-treatment. A sub-group analysis was done stratified by the index specimen histological grade. Results: Seventy nine women were included in this study. Mean age of the study population was 31 years. The LLETZ biopsy in 26 women (32%) showed CIN 2 whilst in 53 women (67%) CIN 3. At
the 6 month follow-up, 13 women (50%) from the CIN 2 group and 26 women (49%) from the CIN3 group had a negative smear. At 12 month follow-up, 20 women (76%) from CIN 2 group and 41 women (77%) from the CIN 3 group had a negative smear. All women had a negative smear at 3 year follow-up. None required a repeat treatment when followed up to five years. Conclusions: In our cohort, most women had no residual CIN at 6 months post-treatment. Follow-up with cytology and/or colposcopy is adequate is this group. M321 CERVICAL IN-SITU SQUAMOUS CELL CARCINOMA AND PREGNANCY M. Jafari Shobeiri1 , H. Esmaeili2 , A. Dastranj Tabrizi1 . 1 Women’s reproductive health research center, Tabriz University of medical Sciences, Tabriz, Iran, Islamic Republic of ; 2 Tabriz University of medical Sciences, Tabriz, Iran, Islamic Republic of Objectives: Squamous cell carcinoma (SCC) is a precursor of cervical invasive cancer. the aim of this study was to evaluate cervical InSitu SCC in situ management during pregnancy. Materials: This prospective study was carried out on 7 patients with SCC in situ of cervix during pregnancy from 2001 to 2011 at Tabriz University of Medical Sciences, Alzahra Hospital. Methods: Cohort study. Results: Seven women with a median age of 36 years were identified. The Pap test results revealed HSIL in 5 and LSIL in 2 of 7 patients. Five patients who had In-Situ SCC diagnosed in the late first trimester underwent cold knife conization at 16 weeks gestation. One woman had placement of a McDonald. One conozation was complicated by excessive blood loss. Two subsequent pregnancies occurred among patients, who were desirous of future fertility. Conclusions: Cold knife conization in pregnancies complicated by cervical In-Situ SCC is safe for mother and fetus. M322 INITIAL EXPERIENCE OF RADICAL HYSTERECTOMY FOR EARLY CERVICAL CANCER IN NEPAL G. Dangal1 . 1 OB/GYN, Kathamndu Model Hospital, Kathmandu, Nepal Objectives: Radical surgery for cervical cancer is a relatively new for Nepal primarily due to lack of expertise. This is to study the profile of patients with early (upto stage IIA) cervical carcinoma who underwent radical hysterectomy. Materials: This was a retrospective analysis of 72 patients who had radical hysterectomy with bilateral pelvic lymphadenectomy for early cervical cancer at the BP Koirala Memorial Cancer Hospital (BPKMCH) and Helping Hands Hospital, Kathmandu from September 1999 to September 2009. Methods: Characteristics such as chief complaint, disease staging and duration, intraoperative and postoperative complications, histopathological findings, need for blood transfusion, and duration of hospital stay were considered for analysis. Results: Radical hysterectomy was performed in 72 women with cervical cancer. Patients’ age ranged from 28–69 years. Age group of 40–49 had highest number of patients (60.3%). The majority of patients were premenopausal women (60.5%) who presented with abnormal vaginal bleeding (71%) as the chief complaint. Most of the patients (54%) had FIGO stage IIA disease. Thirty-one percent had intra-operative and postoperative complications such as wound infection and vessel injury/ureteric injury. All needed blood transfusion before, during, or after the operation, 38% needing four pints. The average duration of hospital stay was 10 days. Of the 72 patients, 67 had squamous cell carcinoma and five had adenocarcinoma. Pelvic lymph node metastasis was found in 22%. Resected margins were adequate in 89.5% of patients.
Poster presentations / International Journal of Gynecology & Obstetrics 119S3 (2012) S531–S867
influence the pregnancy of patients with borderline or malignant ovarian neoplasms and conservative treatment. Once pregnant, they are in high risk for perinatal complications, abortion, premature delivery and recurrence especially, and would be prudent to seek specialized perinatal care. M318 MEIGS’ SYNDROME: CASE REPORT O. Gliozheni1 , E. Kallfa1 , K. Kati1 , E. Ndoni1 . 1 Gynecology, UHOG ‘Koco Gliozheni’, Tirana, Albania Meigs’ syndrome consists of a benign ovarian tumor accompanied by ascites and hydrothorax. Elevated serum carbohydrate antigen 125 (CA-125) levels in postmenopausal women with solid adnexal masses, ascites and pleural effusion are highly suggestive for malignant ovarian tumor. However, patients with Meigs’ syndrome can also have elevated serum CA 125 levels. We are presenting a case of Meigs’ syndrome due to right ovary, with elevated CA 125. M319 COLPOSCOPY IN POSTMENOPAUSAL WOMEN: A NINE YEAR REVIEW E. Moore1 , S. Kumar1 , R. Joseph1 , S. Phadnis1 , M. Padwick1 , A. Sanusi1 . 1 Watford General Hospital, Watford, United Kingdom Objectives: To determine the prevalence of cervical intraepithelial neoplasia (CIN) in women over the age of fifty and study the correlation between cytology and colposcopy. Materials: All women over the age of fifty years attending our colposcopy clinic between 1st January 2002 and 31st December 2011 were identified using the Cyres database. Methods: The primary outcome measure was histology of cervical biopsy. Results: During the study period 3700 women were referred. Histology results for 1216 (33%) women were available. 316/1216 (26%) women had CIN1, 236/1216 (19%) CIN2–3 and 20/1216 (2%) cancer. Of the women diagnosed with cancer two were refereed with borderline or negative smears. The remaining 18 women were referred with severe or suspected glandular abnormalities on cytology, or as an urgent clinical referral. Of the 236 women with CIN2–3, 107/236 (45%) women were referred with negative, borderline or mild dyskaryosis on cytology. 59/107 (55%) were thought to be normal or low grade at colposcopy with 54 (92%) having a satisfactory colposcopy. Of the women with CIN1 31/316 (10%) were referred with moderate or severe smears. Of these 13/31 (42%) were thought to be high grade at colposcopy with 10 (77%) having a satisfactory colposcopy. Conclusions: In our cohort of women over fifty years, there is poor correlation between referral smear and histology. M320 FIVE YEAR FOLLOW UP FOR WOMEN WITH INCOMPLETE ENDOCERVICAL MARGIN FOLLOWING LLETZ S. Kumar1 , R. Joseph1 , E. Moore1 , S. Phadnis1 , M. Padwick1 , A. Sanusi1 . 1 Watford General Hospital, Watford, United Kingdom Objectives: We aim to study the recurrence rate following treatment for high-grade CIN, when residual CIN was present at the endocervical margin of the index specimen. Materials: We performed a cohort study of women who had excisional treatment for high-grade CIN between 1st January 2001 and 31st December 2006. Subjects with LLETZ specimens showing CIN at the endocervical margin were included. Methods: The primary outcome measure was the grade of smear at follow-up post-treatment. A sub-group analysis was done stratified by the index specimen histological grade. Results: Seventy nine women were included in this study. Mean age of the study population was 31 years. The LLETZ biopsy in 26 women (32%) showed CIN 2 whilst in 53 women (67%) CIN 3. At
the 6 month follow-up, 13 women (50%) from the CIN 2 group and 26 women (49%) from the CIN3 group had a negative smear. At 12 month follow-up, 20 women (76%) from CIN 2 group and 41 women (77%) from the CIN 3 group had a negative smear. All women had a negative smear at 3 year follow-up. None required a repeat treatment when followed up to five years. Conclusions: In our cohort, most women had no residual CIN at 6 months post-treatment. Follow-up with cytology and/or colposcopy is adequate is this group. M321 CERVICAL IN-SITU SQUAMOUS CELL CARCINOMA AND PREGNANCY M. Jafari Shobeiri1 , H. Esmaeili2 , A. Dastranj Tabrizi1 . 1 Women’s reproductive health research center, Tabriz University of medical Sciences, Tabriz, Iran, Islamic Republic of ; 2 Tabriz University of medical Sciences, Tabriz, Iran, Islamic Republic of Objectives: Squamous cell carcinoma (SCC) is a precursor of cervical invasive cancer. the aim of this study was to evaluate cervical InSitu SCC in situ management during pregnancy. Materials: This prospective study was carried out on 7 patients with SCC in situ of cervix during pregnancy from 2001 to 2011 at Tabriz University of Medical Sciences, Alzahra Hospital. Methods: Cohort study. Results: Seven women with a median age of 36 years were identified. The Pap test results revealed HSIL in 5 and LSIL in 2 of 7 patients. Five patients who had In-Situ SCC diagnosed in the late first trimester underwent cold knife conization at 16 weeks gestation. One woman had placement of a McDonald. One conozation was complicated by excessive blood loss. Two subsequent pregnancies occurred among patients, who were desirous of future fertility. Conclusions: Cold knife conization in pregnancies complicated by cervical In-Situ SCC is safe for mother and fetus. M322 INITIAL EXPERIENCE OF RADICAL HYSTERECTOMY FOR EARLY CERVICAL CANCER IN NEPAL G. Dangal1 . 1 OB/GYN, Kathamndu Model Hospital, Kathmandu, Nepal Objectives: Radical surgery for cervical cancer is a relatively new for Nepal primarily due to lack of expertise. This is to study the profile of patients with early (upto stage IIA) cervical carcinoma who underwent radical hysterectomy. Materials: This was a retrospective analysis of 72 patients who had radical hysterectomy with bilateral pelvic lymphadenectomy for early cervical cancer at the BP Koirala Memorial Cancer Hospital (BPKMCH) and Helping Hands Hospital, Kathmandu from September 1999 to September 2009. Methods: Characteristics such as chief complaint, disease staging and duration, intraoperative and postoperative complications, histopathological findings, need for blood transfusion, and duration of hospital stay were considered for analysis. Results: Radical hysterectomy was performed in 72 women with cervical cancer. Patients’ age ranged from 28–69 years. Age group of 40–49 had highest number of patients (60.3%). The majority of patients were premenopausal women (60.5%) who presented with abnormal vaginal bleeding (71%) as the chief complaint. Most of the patients (54%) had FIGO stage IIA disease. Thirty-one percent had intra-operative and postoperative complications such as wound infection and vessel injury/ureteric injury. All needed blood transfusion before, during, or after the operation, 38% needing four pints. The average duration of hospital stay was 10 days. Of the 72 patients, 67 had squamous cell carcinoma and five had adenocarcinoma. Pelvic lymph node metastasis was found in 22%. Resected margins were adequate in 89.5% of patients.