Abstract
Study Objective: To evaluate hysteroscopic transcervical resection (TCR) for atypical polypoid adenomyoma of the uterus (APA). Design: Retrospective study (Canadian Task Force classification II-2). Setting: Single tertiary hospital. Patients: Women who underwent TCR for APA at Kawasaki Municipal Hospital between 2003 and 2015. Interventions: Clinical records were obtained. Measurements and Main Results: Thirty-five patients with APA were evaluated. The median patient age was 35 years (range, 23-43 years), and the median tumor diameter was 22 mm (range, 9-51 mm). The median duration of observation after the first TCR was 34.0 months (range, 4.2-133.7 months). In 19 patients, the tumor recurred after the first TCR. A second TCR was performed in 13 patients, 11 of whom experienced recurrence. A third TCR was performed in 7 patients, all 7 of whom experienced recurrence. A fourth TCR was performed in 4 patients, 3 of whom experienced recurrence. The recurrence rate after the second TCR was higher than that after the first TCR (71.4%-84.6% vs 54.3%; p < .01, t test). The median disease-free interval was 12.4 months after the first TCR, 15.3 months after the second TCR, 10.5 months after the third TCR, and 10.9 months after the fourth TCR. Seven patients progressed to endometrial cancer; however, there was no mortality. Six of the 35 patients conceived, and 4 had a normal spontaneous delivery. Conclusion: Owing to disease-free intervals that follow treatment, TCR is a promising treatment modality as a fertility-preserving option for patients with APA under careful observation. Twenty percent of patients with APA develop cancer; however, the present study showed no mortality.
| Original language | English |
|---|---|
| Journal | Journal of Minimally Invasive Gynecology |
| DOIs | |
| Publication status | Accepted/In press - 2017 Jan 1 |
| Externally published | Yes |
Fingerprint
Keywords
- APA
- Hysteroscopy
- Pregnancy
- Recurrence rate
- Uterine cancer
ASJC Scopus subject areas
- Obstetrics and Gynaecology
Cite this
Hysteroscopic Transcervical Resection for Atypical Polypoid Adenomyoma of the Uterus : A Valid, Fertility-Preserving Option. / Chiyoda, Tatsuyuki; Lin, Bao Liang; Saotome, Keiko; Kiyokawa, Shunki; Nakada, Sakura.
In: Journal of Minimally Invasive Gynecology, 01.01.2017.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Hysteroscopic Transcervical Resection for Atypical Polypoid Adenomyoma of the Uterus
T2 - A Valid, Fertility-Preserving Option
AU - Chiyoda, Tatsuyuki
AU - Lin, Bao Liang
AU - Saotome, Keiko
AU - Kiyokawa, Shunki
AU - Nakada, Sakura
PY - 2017/1/1
Y1 - 2017/1/1
N2 - Study Objective: To evaluate hysteroscopic transcervical resection (TCR) for atypical polypoid adenomyoma of the uterus (APA). Design: Retrospective study (Canadian Task Force classification II-2). Setting: Single tertiary hospital. Patients: Women who underwent TCR for APA at Kawasaki Municipal Hospital between 2003 and 2015. Interventions: Clinical records were obtained. Measurements and Main Results: Thirty-five patients with APA were evaluated. The median patient age was 35 years (range, 23-43 years), and the median tumor diameter was 22 mm (range, 9-51 mm). The median duration of observation after the first TCR was 34.0 months (range, 4.2-133.7 months). In 19 patients, the tumor recurred after the first TCR. A second TCR was performed in 13 patients, 11 of whom experienced recurrence. A third TCR was performed in 7 patients, all 7 of whom experienced recurrence. A fourth TCR was performed in 4 patients, 3 of whom experienced recurrence. The recurrence rate after the second TCR was higher than that after the first TCR (71.4%-84.6% vs 54.3%; p < .01, t test). The median disease-free interval was 12.4 months after the first TCR, 15.3 months after the second TCR, 10.5 months after the third TCR, and 10.9 months after the fourth TCR. Seven patients progressed to endometrial cancer; however, there was no mortality. Six of the 35 patients conceived, and 4 had a normal spontaneous delivery. Conclusion: Owing to disease-free intervals that follow treatment, TCR is a promising treatment modality as a fertility-preserving option for patients with APA under careful observation. Twenty percent of patients with APA develop cancer; however, the present study showed no mortality.
AB - Study Objective: To evaluate hysteroscopic transcervical resection (TCR) for atypical polypoid adenomyoma of the uterus (APA). Design: Retrospective study (Canadian Task Force classification II-2). Setting: Single tertiary hospital. Patients: Women who underwent TCR for APA at Kawasaki Municipal Hospital between 2003 and 2015. Interventions: Clinical records were obtained. Measurements and Main Results: Thirty-five patients with APA were evaluated. The median patient age was 35 years (range, 23-43 years), and the median tumor diameter was 22 mm (range, 9-51 mm). The median duration of observation after the first TCR was 34.0 months (range, 4.2-133.7 months). In 19 patients, the tumor recurred after the first TCR. A second TCR was performed in 13 patients, 11 of whom experienced recurrence. A third TCR was performed in 7 patients, all 7 of whom experienced recurrence. A fourth TCR was performed in 4 patients, 3 of whom experienced recurrence. The recurrence rate after the second TCR was higher than that after the first TCR (71.4%-84.6% vs 54.3%; p < .01, t test). The median disease-free interval was 12.4 months after the first TCR, 15.3 months after the second TCR, 10.5 months after the third TCR, and 10.9 months after the fourth TCR. Seven patients progressed to endometrial cancer; however, there was no mortality. Six of the 35 patients conceived, and 4 had a normal spontaneous delivery. Conclusion: Owing to disease-free intervals that follow treatment, TCR is a promising treatment modality as a fertility-preserving option for patients with APA under careful observation. Twenty percent of patients with APA develop cancer; however, the present study showed no mortality.
KW - APA
KW - Hysteroscopy
KW - Pregnancy
KW - Recurrence rate
KW - Uterine cancer
UR - http://www.scopus.com/inward/record.url?scp=85034992026&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85034992026&partnerID=8YFLogxK
U2 - 10.1016/j.jmig.2017.08.659
DO - 10.1016/j.jmig.2017.08.659
M3 - Article
C2 - 29038039
AN - SCOPUS:85034992026
JO - Journal of Minimally Invasive Gynecology
JF - Journal of Minimally Invasive Gynecology
SN - 1553-4650
ER -