Risk for residual adenocarcinoma in situ or cervical adenocarcinoma in women undergoing loop electrosurgical excision procedure/conization for adenocarcinoma in situ.
OBJECTIVE
To evaluate the risk for residual adenocarcinoma in situ (AIS) or cervical adenocarcinoma in women undergoing loop electrosurgical excision procedure (LEEP)/conization as the initial management for AIS.


METHODS
A retrospective chart study was conducted from 1990 to 2005. Patients with AIS were identified from a pathology database.


RESULTS
Forty-three patients were identified with AIS of the cervix who were initially treated with LEEP/conization. Twelve cases of invasive adenocarcinoma (28%) were identified on LEEP/conization. Margin status was available for 41 patients. Twenty (49%) patients had a positive margin, and 21 (51%) patients had a negative margin. Nineteen women with positive margins underwent definitive surgical therapy; 68% had residual AIS. Eleven women with negative margins underwent hysterectomy; 45% had residual AIS. Women with positive and negative margins were compared and found to differ significantly in regard to diagnosis of adenocarcinoma on LEEP/conization.


CONCLUSIONS
Women status post-LEEP/conization for AIS have a high risk of residual AIS, even with negative conization margins. If definitive hysterectomy is deferred, close follow-up is mandatory.
Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Kentucky Markey Cancer Center, 333 Whitney-Hendrickson Building, 800 Rose Street, Lexington, KY 40536-0298, USA. cpdesi00@uky.edu
Christopher P
CP
DeSimone
Misty E
ME
Day
Charles S
CS
Dietrich
Molly M
MM
Tovar
Susan C
SC
Modesitt
D000230:Adenocarcinoma / Q000453:epidemiology / Q000473:pathology / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D000368:Aged; D002278:Carcinoma in Situ / Q000453:epidemiology / Q000473:pathology / Q000601:surgery*; D019092:Conization; D004598:Electrosurgery; D005260:Female; D006801:Humans; D008875:Middle Aged; D018365:Neoplasm, Residual / Q000453:epidemiology / Q000473:pathology / Q000601:surgery; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology* / Q000473:pathology / Q000601:surgery*; D055815:Young Adult