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KMID : 1137020110220010025
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Journal of Gynecologic Oncology
2011 Volume.22 No. 1 p.25 ~ p.31
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The safety of conization in the management of adenocarcinoma in situ of the uterine cervix
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Kim Mi-La
Hahn Ho-Suap
Lim Kyung-Taek
Lee Ki-Heon
Kim Hy-Sook
Hong Sung-Ran
Kim Tae-Jin
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Abstract
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Objective: To evaluate the occurrence of residual or recurrent disease after conization for adenocarcinoma in situ (AIS) of the uterine cervix.
Methods: Medical records of 99 patients with a histologically diagnosis of AIS of the uterine cervix by conization between 1991 and 2008 were reviewed retrospectively.
Results: Seventy eight of 99 patients (78.8%) had negative and 18 (18.2%) had positive resection margins of the conization specimen, and 3 (3.0%) had unknown margin status. Of the 78 patients with negative margins, 45 underwent subsequent hysterectomy and residual AIS were present in 4.4% (2/45) of patients. Ten of the 18 patients with positive margins received subsequent hysterectomy and 3 patients (30%) had residual AIS. Twenty―eight patients had conservative treatment and during the median follow―up time of 23.5 months (range, 7 to 124 months), only one patient (3.6%) had recurrent AIS and was treated with a simple hysterectomy. Eight patients became pregnant after conization, 4 of them delivered healthy babies, one had a spontaneous abortion and 3 were ongoing pregnancies.
Conclusion: Patients with positive resection margins after conization for AIS of the uterine cervix are significantly more likely to have residual disease. However, negative resection margin carries a lower risk for residual AIS, therefore conservative management with careful surveillance seems to be feasible in women who wish to preserve their fertility.
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KEYWORD
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Adenocarcinoma in situ, Uterine cervix cancer, Conization, Conservative treatment
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