Adequacy of Conization Margins in Adenocarcinomain Situof the Cervix as a Predictor of Residual Disease

Im, Dwight D.; Duska, Linda R.; Rosenshein, Neil B.

doi:10.1006/gyno.1995.0003

Cited by 73 publications

(30 citation statements)

References 2 publications

(5 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…4,8,[13][14][15][16][17][18][19][20][21] Most authors believe that a patient with AIS does not require a second cone biopsy or hysterectomy if the margins are free of AIS in the initial cone biopsy specimen. The results of our study generally support this recommendation but they also highlight the context in which the recommendation needs to be made.…”

Section: Discussionmentioning

confidence: 99%

“…However, its routine use has been questioned because m a n y patients with AIS are in their childbearing years and desire to retain their fertility. [4][5][6][7][8] In this context, the cervical cone biopsy has become an important surgical procedure for AIS. The major concern of using the cone biopsy as a definitive surgical procedure is its ability to completely excise the AIS, because any AIS that is left in the uterus has the potential to progress to invasive a d e n o c a r c i n o m a .…”

mentioning

confidence: 99%

See 1 more Smart Citation

The Status and Distance of Cone Biopsy Margins as a Predictor of Excision Adequacy for Endocervical Adenocarcinoma In Situ

Goldstein

Mani

1998

Am J Clin Pathol

View full text Add to dashboard Cite

Cervical cone biopsy has become an important surgical procedure for endocervical adenocarcinoma in situ (AIS), especially for patients who desire to retain their fertility. Establishing the usefulness of the endocervical margin status in cone biopsy specimens as a predictor of residual AIS is paramount. We examined the status of the endocervical margin in the cone biopsy specimen, the distance between the most proximal AIS and the endocervical margin in the cone biopsy specimen, and the endocervical curettage (ECC) specimen performed at the time of cone biopsy and residual AIS in the hysterectomy specimens of 61 patients with specimens accessioned from 1968 through 1997; 43 (30%) of patients with a negative endocervical margin had residual AIS in the hysterectomy specimen. Conversely, 10 of 18 (56%) patients with a positive endocervical margin in the cone biopsy Endocervical adenocarcinoma in situ (AIS) is an acknowledged precursor lesion of invasive endocervical adenocarcinoma.1-3 Hysterectomy has been the traditional surgical procedure for AIS. However, its routine use has been questioned because m a n y patients with AIS are in their childbearing years and desire to retain their fertility. [4][5][6][7][8] In this context, the cervical cone biopsy has become an important surgical procedure for AIS. The major concern of using the cone biopsy as a definitive surgical procedure is its ability to completely excise the AIS, because any AIS that is left in the uterus has the potential to progress to invasive a d e n o c a r c i n o m a . Predicting w h i c h patients have a high likelihood of having residual AIS in the uterus after cone biopsy is paramount. The specimen had no AIS in the hysterectomy specimen. All 6 patients with AIS in the ECC specimen had residual AIS. No patient with an endocervical margin in the cone biopsy specimen greater than 10 mm had residual AIS. Patients with distances less than 10 mm had equal percentages of residual AIS. In general, more patients with a negative endocervical margin in the cone biopsy specimen had no residual AIS in the hysterectomy specimen than those with a positive endocervical margin in the cone biopsy specimen. However, the status of this margin is not useful for p r e d i c t i n g the p r e s e n c e of r e s i d u a l AIS. Pathologists should report the distance between the endocervical cone biopsy margin and the closest AIS. (Key words: Cervix; Endocervix; Adenocarcinoma in situ; Cone biopsy; Margins) Am J Clin Pathol 1998,109:727-732. status of the margins in the cone biopsy specimen is a histologic feature that would seem to be predictive of residual AIS in the uterus, but some studies have suggested that this may not be the case. Furthermore, the optimum minimal distance between the endocervical margin in a cone biopsy specimen and AIS that would markedly reduce the likelihood of residual AIS has yet to be established. We retrospectively studied the specimens of patients with AIS who had undergone a cervical cone biopsy followed by hysterectomy to determin...

show abstract

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

The Status and Distance of Cone Biopsy Margins as a Predictor of Excision Adequacy for Endocervical Adenocarcinoma In Situ

Goldstein

Mani

1998

Am J Clin Pathol

View full text Add to dashboard Cite

show abstract

“…Negative margins, while promising in young women and if a 10 mm clear margin can be obtained, 42,43 are no assurance of freedom from disease. [44][45][46][47] Conversely, positive margins are not universally indicative of residual AIS. 43 Some warn against a potential risk of overtreatment and causing unnecessary stress in the patient if further treatment is based solely on the status of the cone margins.…”

Section: Discussionmentioning

confidence: 99%

Atypical Papanicolaou Smear in Pregnancy

Connolly¹,

Evans²

2005

Clinical Medicine & Research

View full text Add to dashboard Cite

Papani colaou (Pap) smears that contain atypical squamous cells of undetermined significance can be followed up with repeat smears. However, those that contain atypical glandular cells (AGC) are more likely to be associated with severe underlying conditions and, therefore, warrant particular attention. 1 The diagnosis of AGC by pathologists is difficult as there is a high degree of interobserver variation. [2][3][4][5][6][7] Up to 50% of women with AGC have significant histologic abnormalities, and cancer is present in 19.5% of women with AGC.

show abstract

“…On the other hand squamous cell carcinoma in situ has been well studied and the progression of dysplasia to invasive disease is very clear defined. The rare incidence of AIS makes very difficult the delineation of natural history of glandular dysplasia which could consist the precursor of cervical AIS [18][19][20][21][22][23][24][25].…”

Section: Diagnosis and Pathogenesismentioning

confidence: 99%

Cervical Adenocarcinoma In situ Presentation of the Case and Review of Incidence, Recurrence Rate and Therapeutic Options

Zoi¹,

Paraskeui²

2015

Gynecol Obstet (Sunnyvale)

View full text Add to dashboard Cite

Cervical adenocarcinoma in situ (AIS) is a Adenocarcinoma in situ of the cervix (AIS) is a premalignant lesion that was first described by Helper in 1952 in his review of adenocarcinoma of the cervix.The following year Friedal reported two women who had undergone therapy for squamous cervical lesions and had concomitant cervical AIS.These authors postulated that this glandular lesion was a precursor to invasive adenocarcinoma similar to preinvasive squamous cell carcinoma in situ. An increase in the incidence of cervical AIS has been reported in recent years. In this fact may contributed an increased prevalence of HPV18, the pathologist's awareness of the lesion and an increase in use of oral contraceptives.

show abstract

Adequacy of Conization Margins in Adenocarcinomain Situof the Cervix as a Predictor of Residual Disease

Cited by 73 publications

References 2 publications

The Status and Distance of Cone Biopsy Margins as a Predictor of Excision Adequacy for Endocervical Adenocarcinoma In Situ

The Status and Distance of Cone Biopsy Margins as a Predictor of Excision Adequacy for Endocervical Adenocarcinoma In Situ

Atypical Papanicolaou Smear in Pregnancy

Cervical Adenocarcinoma In situ Presentation of the Case and Review of Incidence, Recurrence Rate and Therapeutic Options

Contact Info

Product

Resources

About