[Persistence and recurrence of in situ cervical adenocarcinoma after primary treatment. About 121 cases].
OBJECTIVE
The aim of this study is to assess the results of conservative management of adenocarcinoma in situ (AIS) of the uterine cervix.


METHODS
Retrospective multicentric study with 121 cases. Patients with cervical invasive lesions were excluded. General characteristics of population, diagnosis circumstances, treatment, histology and evolution were studied.


RESULTS
Conservative treatment was performed in 98.3% of cases with 64% of negative margins. In the positive margins group, 80% of conservative treatments were performed by electrosurgical loop. Length of cone resection is significantly higher for conization with negative margins (p<0.001). The rate of residual lesion was 18% in negative margins group and 46% in positive margins group. Two noninvasive and one invasive recurrence were deplored.


CONCLUSIONS
Conservative surgery for patients with AIS could be considered in young patients but several conditions should be respected: careful follow-up after conservative treatment; cold knife conization; length of cone specimen greater than 25 mm and negative margins.
Service de gynécologie-obstétrique, institut Mère-Enfant-Alix-de-Champagne, centre hospitalier universitaire, 45, rue Cognacq-Jay, 51092 Reims cedex, France. frederic.dedecker@wanadoo.fr
F
F
Dedecker
O
O
Graesslin
S
S
Bonneau
C
C
Quéreux
D000230:Adenocarcinoma / Q000473:pathology / Q000601:surgery*; D000328:Adult; D000367:Age Factors; D000368:Aged; D002278:Carcinoma in Situ / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology / Q000517:prevention & control*; D009367:Neoplasm Staging; D030361:Papillomavirus Infections / Q000473:pathology / Q000601:surgery*; D012189:Retrospective Studies; D018570:Risk Assessment; D016896:Treatment Outcome; D002583:Uterine Cervical Neoplasms / Q000473:pathology / Q000601:surgery*