Metastatic Carcinomas at the Episiotomy Site: A Systematic Literature Review
Rattachement africain : it, mx, gr, ru. Niveau de preuve : code pays fourni par la source.
Le résumé fourni par la source
Background/Objectives: Rarely, primary (PriCs) or metastatic (metECs) carcinomas occur in the episiotomy site. Methods: A systematic literature review of metECs was carried out. We reviewed the PRISMA guidelines and the Scopus, Pubmed, and Web of Science databases. Results: We found 21 carcinomas; all of them were cervical carcinomas (11 squamous, SCC; 6 adenocarcinomas; 3 adenosquamous; 1 SCC or adenocarcinoma) diagnosed during pregnancy (38%) or 0.25–8 months postpartum (57%). SCCs were larger (mean size: 4.8 cm). At presentation, only two cases were pN+, and no distant metastases were found, excluding four episiotomy metastases (one anticipating the cervical cancer diagnosis); the remaining episiotomy metastases (mean size: 3 cm; one multifocal) were found at follow-up (these were first metastases in 86% of cases). The time range from the episiotomy/last delivery to first episiotomy metastasis was 1–66 (mean, 12.3) months. Treatment was variable: hysterectomy (71%) ± lymphadenectomy (67%) and/or adjuvant treatment (19%); chemoradiation/radiotherapy alone (24%). A total of 90% of cases recurred after 18 days to 66 months (mean, 12 months). At last follow-up, ten patients (48%) were disease-free after 12–120 (mean, 63.5) months, two patients (10%) were alive with disease, and nine (42%) patients died of disease after 6–36 (mean, 12.5) months (including two never-cleared/progressing cases). Conclusions: PriCs and metECs are rare. Iatrogenic/obstetric implantation or vascular dissemination of cervical cancer at the site of episiotomy may occur. For episiotomy lesions, accurate gynecological/perineal examination is required, and biopsy can be considered. Larger studies are required in order to determine treatment guidelines. Compared to PriCs, metECs occurred in younger (premenopausal) patients, were not associated with endometriosis, and demonstrated slightly smaller size and shorter mean time from episiotomy to episiotomy metastases, with a higher likelihood of a less favorable prognosis.
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Metastatic Carcinomas at the Episiotomy Site: A Systematic Literature Review
- Date Crossref
- 27/08/2025
- Éditeur
- MDPI AG
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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University of Modena and Reggio Emilia Clinical and Experimental Medicine PhD Program pays non établi dans la noticeUniversité ou école supérieure
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Azienda Sanitaria Unità Locale di Reggio Emilia pays non établi dans la noticeÉtablissement de santé
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Istituti di Ricovero e Cura a Carattere Scientifico pays non établi dans la noticeÉtablissement de santé
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Universidad Politécnica Metropolitana de Hidalgo pays non établi dans la noticeUniversité ou école supérieure
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University of Catania Department of Medical and Surgical Sciences and Advanced Technologies “G.F. Ingrassia” Anatomic Pathology pays non établi dans la noticeUniversité ou école supérieure
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University of Foggia Policlinico Foggia pays non établi dans la noticeUniversité ou école supérieure
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National and Kapodistrian University of Athens Medical School pays non établi dans la noticeUniversité ou école supérieure
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LETO Maternity Hospital pays non établi dans la noticeÉtablissement de santé
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National Medical Research Center for Obstetrics pays non établi dans la noticeStructure de recherche
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Pathology Unit pays non établi dans la noticeInstitution
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Department of Obstetrics and Neonatology pays non établi dans la noticeInstitution
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Laboratory of Translational Research pays non établi dans la noticeStructure de recherche
Clinical and Experimental Medicine PhD Program — University of Modena and Reggio Emilia, Azienda Sanitaria Unità Locale di Reggio Emilia et Istituti di Ricovero e Cura a Carattere Scientifico, avec 9 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.