Postconization surveillance of cervical adenocarcinoma in situ. A prospective trial.
OBJECTIVE
To conduct a surveillance trial after conization to prospectively determine the outcome of conservative management of adenocarcinoma in situ (AIS).


METHODS
Women diagnosed with AIS were prospectively enrolled from September 2000 to September 2001. Eligibility criteria included patient age younger than 40 years, prior conization with negative margins and the desire to preserve fertility. Each cone biopsy specimen was secondarily reviewed. Postconization surveillance consisted of a liquid-based Pap test and endocervical curettage (ECC) every 4 months. Follow-up ended in September 2002.


RESULTS
Ten women with a median age of 32 years (range, 26-37) were enrolled. Six were nulliparous and 2 primiparous. Seven patients were clinically free of disease after a median of 21 months (range, 5-24), 2 were lost to follow-up, and 1 was excluded when AIS could not be confirmed on the original specimen. Twenty-eight Pap smears and 18 ECCs were performed, but no additional surgical procedures were required due to abnormal cytopathology.


CONCLUSIONS
This prospective trial on postconization surveillance demonstrated the safety of conservative management for AIS patients desiring to preserve fertility.
Schorge
John O
JO
Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Department of Pathology, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, J7.124, Dallas, TX 75390-9032, USA. john.schorge@utsouthwestern.edu
Lea
Jayanthi S
JS
Ashfaq
Raheela
R
D000230:Adenocarcinoma / Q000473:pathology / Q000601:surgery*; D000328:Adult; D002278:Carcinoma in Situ / Q000473:pathology / Q000601:surgery*; D019092:Conization / Q000379:methods*; D005260:Female; D005298:Fertility; D006801:Humans; D009364:Neoplasm Recurrence, Local / Q000473:pathology / Q000601:surgery*; D011184:Postoperative Period; D011446:Prospective Studies; D016896:Treatment Outcome; D002583:Uterine Cervical Neoplasms / Q000473:pathology / Q000601:surgery*