Adenocarcinoma in Situ of the Uterine Cervix: An Experience with 100 Cases

Östör, Andrew G.; Duncan, Alistair; Quinn, Michael; Rome, Robert M.

doi:10.1006/gyno.2000.5957

Cited by 109 publications

(27 citation statements)

References 21 publications

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“…It has been suggested that women who have been treated for cervical AIS require long-term surveillance for at least 10 years regardless of whether they have undergone hysterectomy or conservative management, as the risk of invasive cervical cancer remains five times greater than the general population [28,29]. To date, the longest surveillance reported in a series of patients treated by conization alone was eight years [30]. …”

Section: Discussionmentioning

confidence: 99%

Risk of residual disease and invasive carcinoma in women treated for adenocarcinoma in situ of the cervix

Costales

Milbourne

Rhodes

et al. 2013

Gynecologic Oncology

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Objective Cervical adenocarcinoma in situ (AIS) is increasing in incidence among reproductive-age women. Cervical conization is an alternative to hysterectomy that allows future fertility, however reports regarding the risk of residual AIS and underlying adenocarcinoma are conflicting. The purpose of this study was to determine the outcomes of a large cohort of women treated for AIS. Methods The medical records of 180 women with cervical AIS evaluated at the University of Texas MD Anderson Cancer Center and its outlying clinics between 1983 and 2011 were reviewed for demographic information, treatment history, pathologic findings and outcomes. Results The mean age at diagnosis was 33.8 years (range 17.6-76.1 years). 172 of the 180 women had at least one cone biopsy performed, with 110 (64.0%) undergoing a cold knife cone (CKC), and 62 (36.0%) undergoing a loop electrosurgical excision procedure (LEEP) as their initial method of treatment. Positive margins were noted in 35.0% of patients undergoing CKC compared with 55.6% undergoing LEEP (p=0.017). 71 patients ultimately underwent hysterectomy with residual disease noted in 10 patients (14.1%), 8 patients (11.3%) with residual AIS and 2 patients (2.8%) with invasive carcinoma. Of the 101 patients who did not undergo hysterectomy, 2 patients (2.0%) developed recurrent AIS at a median of 27.5 months (range 18- 37 months) from the last cone, and none developed invasive carcinoma. Conclusion Patients undergoing conservative management for AIS with cervical conization alone should be monitored closely and counseled regarding the potential risks of residual and recurrent disease, even when negative cone margins are obtained.

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Section: Discussionmentioning

confidence: 99%

Risk of residual disease and invasive carcinoma in women treated for adenocarcinoma in situ of the cervix

Costales

Milbourne

Rhodes

et al. 2013

Gynecologic Oncology

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“…12 Furthermore, the complex architecture of endocervical glands, with invagination, branching, and tunnel formation makes determination of depth of invasion problematic. 13 Bisseling et al 14 performed a retrospective review of the treatment of cervical microinvasive adenocarcinoma, in which 16 patients with stage IA1 disease were managed with conization.…”

Section: Cervical Cancermentioning

confidence: 99%

Fertility preserving options in patients with gynecologic malignancies

Eskander¹,

Randall²,

Berman³

et al. 2011

American Journal of Obstetrics and Gynecology

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A proportion of reproductive age women are affected by gynecologic malignancies. This patient population is faced with difficult decisions, related to their cancer care and treatment, as well as future childbearing potential. Therefore, it is important for gynecologists to be familiar with fertility sparing management options in patients with cervical, ovarian, and endometrial cancer. In addition to understanding the surgical approaches available, providers should be able to counsel patients regarding their eligibility for and the indications and limitations of fertility sparing therapy for gynecologic cancer, allowing for appropriate referrals. A comprehensive PUBMED literature search was conducted using the key words “fertility preservation,” “cervical cancer,” “endometrial cancer,” “ovarian cancer,” “borderline tumor of the ovary,” “germ cell tumor,” “obstetrical outcomes,” “chemotherapy,” and “radiation.” The following review summarizes fertility sparing options for patients with cervical, ovarian and endometrial cancer, with an emphasis on appropriate patient selection, oncologic, and obstetric outcomes.

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“…H&E Since only a few glands may be affected and be focally distributed, they may be overlooked unless serial sections of a cone biopsy are examined. If the lesion is overlooked or incompletely excised, it will progress to invasive adenocarcinoma Wells and Brown 1986;Östör et al 2000). Since both glandular and squamous cells of the endocervix may originate from the subcolumnar reserve cell (Alva and Lauchlan 1975;Christopherson et al 1979;Tase et al 1989), their precancerous and neoplastic changes are often closely related.…”

Section: Adenocarcinoma In Situ [8140/2] (Figs 141-149)mentioning

confidence: 99%

Color Atlas of Histopathology of the Cervix Uteri

Dallenbach-Hellweg¹,

Doeberitz²,

Trunk³

2006

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The new edition of this atlas integrates all significant advances made in the past 15 years in molecular pathology, tumor virology, and genetics of cervical cancer. It emphasizes the importance of these advances in facilitating its pathological diagnosis and in optimizing clinical management and prognosis. A new chapter on immunohistochemistry has been added, which includes refined detection methods, e.g., the overexpression of p16INK4a as a molecular marker in the early differential diagnosis of premalignant lesions. The section on etiology and pathogenesis in human papillomavirus-induced neoplasia has been incorporated to represent new insights into the sequences of cellular and nuclear deregulation at the molecular level. All chapters have been revised to include the newest advances and relevant experiences in how to interpret and manage cervical disease; they are supported by the addition of 35 new microphotographic illustrations. The tumor nomenclature is adapted to the latest edition of the WHO classification; the morphology code of the international classification of diseases for oncology (ICD-O) has been added. We have also updated the list of references by adding recent relevant publications.Again, the staff of Springer-Verlag deserve our thanks for their patience and skill in preparing the manuscript and in reproducing the microphotographs. Preface to the First Edition During the past decade our understanding of the histopathology of the cervix uteri has changed greatly. Because of the lifestyles of the modern permissive society, cervical viral infections have become epidemic, resulting in inflammatory and precancerous lesions that were uncommon but now are seen mainly in the younger age groups with increasing frequency. Then too, progress in molecular biology and immunohistochemistry has enabled us to distinguish subtypes of papilloma viruses, to proceed in understanding their action within the genome, and to trace the infected metaplastic and neoplastic-transformed cells to their histogenetic origins. The resultant refined classification of cervical neoplasias has helped to predict clinical outcome and to choose type of therapy.This atlas is intended for all pathologists, to aid them in their routine diagnostic work. We hope it explains just how comprehensive, important and complex the histopathology of the cervix uteri has become during the last few years. It covers all pertinent differential diagnostic aspects and describes in detail how to reach the correct diagnosis. The atlas is also meant for the clinician, to guide him in his often difficult decision of how to provide optimal care for the frequently young patient, who desires children but is at risk for cancer. In particular, the atlas is designed to foster an improved dialogue between the pathologist and the clinician.The microphotographs were selected from our daily diagnostic material, since they show best the technical variations confronting the clinical pathologist in his daily routine, where effects of specimen transport, differences in ...

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Adenocarcinoma in Situ of the Uterine Cervix: An Experience with 100 Cases

Cited by 109 publications

References 21 publications

Risk of residual disease and invasive carcinoma in women treated for adenocarcinoma in situ of the cervix

Risk of residual disease and invasive carcinoma in women treated for adenocarcinoma in situ of the cervix

Fertility preserving options in patients with gynecologic malignancies

Color Atlas of Histopathology of the Cervix Uteri

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