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Background: Performing lymphadenectomy in all patients with early-stage endometrial cancer (EC) is debatable because the procedure may expose patients to unnecessary risks of postoperative complications. Aim of this study was to evaluate the prevalence and risk factors of pelvic lymph node metastasis (PLNM) in patients with apparently early-stage EC., Materials and Methods: Two hundred and two patients with apparently early-stage EC who underwent surgical staging at Thammasat University Hospital between the years 2013 and 2020 were included in this retrospective study. Clinicopathological data and preoperative laboratory results were obtained from computer-based medical records. All data were statistically analyzed to determine the prevalence of PLNM and risk factors for developing PLNM., Results: PLNM was detected in 22 (10.9%) patients. Univariate analysis demonstrated that having grade 3 tumor, myometrial invasion of 50% or greater, vaginal involvement, cervical involvement, adnexal involvement, lower uterine segment involvement, lymphovascular space invasion (LVSI), and positive peritoneal cytology were associated with higher risk for developing PLNM. In addition, lower preoperative hemoglobin level and higher preoperative white blood cell count were significantly associated with PLNM. Multivariate analysis demonstrated that myometrial invasion of 50% or greater and LVSI were independent risk factors for developing PLNM (odds ratio (OR) 9.31, 95% confidence interval (CI) 2.58-33.55, p = 0.001, and OR 3.73, 95%CI 1.39-10.02, p = 0.009, respectively)., Conclusions: Myometrial invasion of 50% or greater and LVSI were independent risk factors for developing PLNM in patients with apparently early-stage EC and thus lymphadenectomy in these patients should be provided.

Objective: To determine predictors of having cervical intraepithelial neoplasia (CIN) 1 or less in loop electrosurgical excision procedure (LEEP) specimens of patients with colposcopic directed biopsy-confirmed CIN 2-3. Methods: Two hundred and eighty patients with colposcopic directed biopsy-confirmed CIN 2-3 who subsequently underwent LEEP were enrolled in the retrospective study. Related clinical data were collected to determine the predictors of CIN 1 or less in LEEP specimens. Results: CIN 1 or less in LEEP specimens was found in 71 (25.4%) of 280 patients. Multivariate logistic regression analyses demonstrated that nulliparity [OR (95% CI) = 3.375 (1.245-9.150)], low grade Papanicolaou (Pap) results [OR (95% CI) = 6.410 (2.877-14.280)] and low grade colposcopic impression [OR (95% CI) = 16.506 (5.844-46.632)] were significant risk factors of having CIN 1 or less in LEEP specimens. Neither persistent nor recurrent CIN 2-3 was detected in 71 patients who had CIN 1 or less in LEEP specimens. However, persistent or recurrent CIN 2-3 developed in 3 out of 209 (1.4%) patients with CIN 2-3 found in LEEP specimens. Conclusion: Approximately 25% of patients with CIN 2-3 in colposcopic directed biopsy specimens had CIN 1 or less found in LEEP specimens. Predicting factors of having CIN 1 or less in LEEP specimens were nulliparity, low grade Pap results and low grade colposcopic impression., (Creative Commons Attribution License)

Purpose: To study clinical factors related to adequacy of transformation zone (TZ) components in cervical smears., Materials and Methods: Medical and Papanicolaou (Pap) smear reports from Thammasat University Hospital, Thailand during January to December 2015 were collected. Demographic data was reviewed by attending physicians and impact of clinical factors onTZ adequacy was primary outcome. A total of 3,251 smears were reviewed. Finally, 2,098 smears met The inclusion criteria and enrolled into this study., Results: Average age and bodyweight of participants in this study were 43.0 years and 60.0 kg, respectively. Ninety seven percent of smears were classified as satisfactory for evaluation according to the Bethesda system 2001. Adequacy (group A) and inadequacy (group B) of TZ were equal in percentage (50.9/46.0). Prevalence of abnormal cervical cytology was 4.4%. Percentages of abnormal Pap smears in group A and B were 7.3 and 1.4, respectively (p<0.001). Factors associated with increased adequacy of TZ were old-age (≥ 50 yr), nulliparity, within 3-months postpartum, history of TZ inadequacy and abnormal smears. Sexually transmitted disease (STD), hormonal usage, previous cryotherapy and smears collected by staff were associated with inadequacy of TZ., Conclusions: Collection of cervical specimens should be carefully performed. STD history, hormonal usage and previous cryotherapy are risk factors for TZ inadequate specimens.

Background: Time to colposcopy (TC) after abnormal Pap smears was evaluated for influence on cytohistologic correlation (CHC)., Materials and Methods: This retrospective study assessed the correlation between TC and CHC of women who had abnormal Pap smears. Colposcopic chart review included participants from 2010- 2013 who attended a colposcopic clinic, Thammasat University Hospital, Thailand., Results: Four hundred and sixty cases who had abnormal Pap smears were recruited. Pap reports were atypical smears with low grade squamous intraepithelial lesion (SIL), high grade SIL and cancer at 339, 114 and 7 cases, respectively. One hundred and twenty four patients underwent loop electrosurgical excision procedure (LEEP). A half of the cases were colposcopically examined within 1-2 months after abnormal Pap collection. CHC was 88 percent and not affected at all by TC. Subjects who attended cervical cancer screening from affiliated health providers had shorter TC than those screened in our tertiary hospital., Conclusions: Time to colposcopy with abnormal Pap smears conducted at Thammasat University Hospital had a highest frequency of 42 days, in line with the literature. Length of TC does not affect the correlation between Pap and histopathologic reports. A longer waiting period for colposcopy did not alter progression or regression of the disease.