Risk of Cervical Neoplasia Following Adenocarcinoma in Situ
Adenocarcinoma in situ of the uterine cervix is often detected as an incidental finding on excision specimens for high-grade squamous dysplasia (cervical intraepithelial neoplasia 2 and 3). In this study, Munro et al. (AJOG, 2017) sought to determine what factors following loop electrosurgical excision or cold knife cone biopsy affect disease persistence or progression.
Retrospective Cohort Study
298 women were included in the study. 76.5% of patients were initially treated by loop electrosurgical excision procedure, and 23.5% were treated with cold knife biopsy. Mean age was 31.2 years of age (range 18-68) and average length of follow-up was 2.4 years (range 0.3-12.2). Greater risk of disease persistence or recurrence was associated with age >30 years, pure adenocarcinoma in situ lesions, and lesions >8mm. The authors suggest that in women younger than 30 years old, with incidentally detected adenocarcinoma in situ that are <8mm in size and with clear margins may not require reexision.
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