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Cervical Adenocarcinoma in Situ: A Systematic Review of Therapeutic Options and Predictors of Persistent or Recurrent Disease

2001; Lippincott Williams & Wilkins; Volume: 56; Issue: 9 Linguagem: Inglês

10.1097/00006254-200109000-00023

1533-9866

Thomas C. Krivak, G. Scott Rose, John W. McBroom, Jay W. Carlson, William E. Winter, Edward R. Kost,

Uterine Myomas and Treatments

The incidence of cervical adenocarcinoma in situ is increasing in frequency, and our limited knowledge about this lesion presents the physician with a therapeutic dilemma. Treatment for this lesion has included conservative therapy, large loop excision or cold-knife cone biopsy, or definitive therapy consisting of hysterectomy. But, rates of residual adenocarcinoma in situ after cone biopsy with negative margins vary from 0% to 40%, and residual disease rates as high as 80% have been noted when the margins are positive. Despite these recent data on follow-up after conservative therapy such as cone biopsy, it seems that this method is safe and gaining acceptance by many physicians and patients. However, the short follow-up duration and small number of patients limit the conclusions of many studies. The relative infrequency of this diagnosis has precluded extensive clinical experience with the natural history of this lesion. Target Audience: Obstetricians & Gynecologists, Family Physicians Learning Objectives After completion of this article, the reader will be able to summarize the current data on the treatment of adenocarcinoma in situ of the cervix, to outline potential treatment options for the patient with adenocarcinoma in situ of the cervix, and to list the factors associated with disease recurrence.