Cervical adenocarcinoma in situ: the predictive value of conization margin status

Am J Obstet Gynecol. 2007 Aug;197(2):195.e1-7; discussion 195.e7-8. doi: 10.1016/j.ajog.2007.04.035.

Abstract

Objective: We evaluated the impact of conization margin status on outcomes of patients diagnosed with cervical adenocarcinoma in situ.

Study design: A retrospective chart review identified patients at a University hospital from 1988-2006 with adenocarcinoma in situ (AIS) on conization.

Results: Seventy-four patients were included. Median follow-up was 26 months. Twenty-two of 74 patients (30%) had positive margins, 46 patients (62%) had negative margins, and 6 patients had indeterminate margins. Of patients with positive margins, 55% (12/22) were diagnosed with residual or recurrent disease, including 3 patients diagnosed with adenocarcinoma on hysterectomy. Thirteen percent of patients with negative conization margins (6/46) were diagnosed with residual or recurrent disease, including 2 patients diagnosed with adenocarcinoma during follow-up. Cold knife conization resulted in a significantly higher number of negative margins compared to other conization procedures (P = .013).

Conclusions: Even with negative conization margins, women still face a risk of residual, recurrent, or invasive disease.

MeSH terms

  • Adenocarcinoma / pathology*
  • Adolescent
  • Adult
  • Aged
  • Carcinoma in Situ / pathology*
  • Cervix Uteri / pathology*
  • Conization*
  • Female
  • Humans
  • Middle Aged
  • Neoplasm, Residual
  • Predictive Value of Tests
  • Retrospective Studies
  • Uterine Cervical Neoplasms / pathology*