title: Adenocarcinoma in situ of the uterine cervix: an experience with 100 cases.
abstract: OBJECTIVE
  The aim of this study was to ascertain whether cold knife conization alone for cervical adenocarcinoma in situ is safe.
  
  
  METHODS
  One hundred consecutive patients with a histologically proven adenocarcinoma in situ (AIS) of the cervix were studied from 1970 to 1992.
  
  
  RESULTS
  Ninety-two women presented with abnormal smears, and of these 56% contained abnormal glandular cells. Sixty-seven (74%) of 90 women who underwent colposcopy had an abnormal examination, but a glandular abnormality was suspected in only 19 (28%). In all, 80 cold knife conizations were performed. In 7, no abnormality was found following punch biopsy. The margins were free of disease in 55 (75%). The most commonly involved margin in the remainder was the apical. Conization was followed by hysterectomy in 20 women: in 8 of these the cone margins were free and residual disease was found in 2 of the extirpated uteri: as these were extramural cases, inadequate sampling could not be excluded. Of the 12 women where hysterectomy followed conization with diseased margins, 9 had residual disease in the hysterectomy specimen. The definitive therapy was cold knife conization in 56 patients, hysterectomy in 38, and electrocoagulation diathermy in 6. Follow-up of the 53 patients treated by conization alone ranging from 1 to 16 years, with a mean of 8 years (3 have been lost to follow-up) revealed no recurrence of AIS or adenocarcinoma to date.
  
  
  CONCLUSIONS
  It is concluded that cold knife conization is a safe therapeutic modality, provided that the cone biopsy has been adequately sampled and the margins are free.
authors.affiliation: Department of Pathology, University of Melbourne, Melbourne, Victoria, 3053, Australia. a.ostor@pathology.unimelb.edu.au
authors.forename: A G
authors.initials: AG
authors.lastname: Ostör
authors.forename: A
authors.initials: A
authors.lastname: Duncan
authors.forename: M
authors.initials: M
authors.lastname: Quinn
authors.forename: R
authors.initials: R
authors.lastname: Rome
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D000368:Aged; D002278:Carcinoma in Situ / Q000473:pathology / Q000601:surgery*; D019092:Conization; D003452:Cryosurgery; D005260:Female; D006801:Humans; D007044:Hysterectomy; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome; D002583:Uterine Cervical Neoplasms / Q000473:pathology / Q000601:surgery*; D014626:Vaginal Smears