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- 저자 : Bruno Ghiringhello (검색결과 1 건)
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Mario Preti,Lauro Bucchi,Bruno Ghiringhello,Silvana Privitera,Valentina Frau,Elisabetta Corvetto,Chiara Benedetto,Leonardo Micheletti 대한부인종양학회 2017 Journal of Gynecologic Oncology Vol.28 No.4
Objective: To evaluate the prevalence and risk factors for unrecognized invasive carcinomain a series of patients undergoing surgical excision after an office biopsy of vulvar high-gradesquamous intraepithelial lesion (VHSIL). Methods: Two hundred and sixteen consecutive patients treated in a tertiary-level referralcenter for vulvar disease in north-western Italy were recruited. Patients' records werereviewed by trained personnel. Factors showing a statistically significant (p<0.05) associationwith detection of stromal invasion at excisional surgery in univariate analysis were furtherexamined in a backward stepwise multiple logistic regression model. Results: The median patient age was 50 years (range, 19–88). More than 25% patients withVHSIL at biopsy had associated cervical/vaginal intraepithelial neoplasia, and more than 35%had a multifocal lesion. Invasive carcinoma was detected in surgical specimens from 24 patients(11%). The depth of stromal invasion varied between 0.1 mm and 3.0 mm with a median of 0.5mm. In multivariate analysis, the risk of invasive carcinoma detection was greater for patients inthe highest tertile of age (p=0.008), for patients with a lesion ≥20 mm in size (p=0.013) and withclitoral involvement (p<0.001), and for patients presenting with a nodular lesion (p=0.078). Conclusion: Our study suggests that patient age, lesion size, clitoral involvement andnodular appearance in patients with VHSIL at vulvoscopy-directed biopsy are independentlyassociated with the risk of unrecognized invasive carcinoma.
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