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Adenocarcinoma in Situ of the Uterine Cervix—A Systematic Review
  1. Astrid Baalbergen, MD* and
  2. Theo J.M. Helmerhorst, MD, PhD
  1. *Department of Obstetrics and Gynecology, Reinier de Graaf Hospital, Delft, the Netherlands; and
  2. Department of Obstetrics and Gynecology, Erasmus MC University Medical Center, Rotterdam, the Netherlands.
  1. Address correspondence and reprint requests to Astrid Baalbergen, MD, Department of Obstetrics and Gynecology, Reinier de Graaf Hospital, PO Box 5011, 2600 GA Delft, The Netherlands. E-mail: baalbergen@rdgg.nl.

Abstract

Objective This study aimed to review literature if therapeutic strategies in adenocarcinoma in situ of the cervix could lead to a more conservative approach.

Methods A review of the literature was conducted using a Medline search for articles published between 1966 and 2013.

Results Thirty-five studies showed that after a radical cone, 16.5% residual disease in the re-cone or uterus was found. After cone with positive margins, residual abnormalities were found in 49.3%. Thirty-seven studies showed 5% recurrence rate after conservative therapy (large loop excision transformation zone–cold knife conization. After conization with negative margins, the risk of recurrence was 3%.

Conclusions Adenocarcinoma in situ is a relatively rare premalignant but increasingly frequent lesion of the cervix. Although there is a risk of relapse (3%) with a chance of malignancy (<1%), this risk is so small that conservative treatment with negative margins by large loop excision transformation zone or cold knife conization is justified and justifiable not only for women to have children.

  • Adenocarcinoma in situ
  • Conservative therapy
  • LEEP

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Footnotes

  • The authors declare no conflicts of interest.

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