ADEQUACY OF CONIZATION MARGINS IN ADENOCARCINOMA IN-SITU OF THE CERVIX AS A PREDICTOR OF RESIDUAL DISEASE

In this retrospective analysis, 18 patients with adenocarcinoma in sit u (AIS) of the cervix diagnosed on cervical conization between April 1 988 and June 1994 were identified, The margins of all specimens were a ssessed for disease involvement, If hysterectomy or repeat conization was performed, the presence of AIS in the specimen was ascertained. El even of 18 conizations (61%) had AIS with negative margins of resectio n, Two of these 11 patients (18%) were followed conservatively and hav e had negative Pap smears for a mean of 1.7 years, The remaining 9 pat ients (82%) were treated by hysterectomy, with 4 (44%) showing residua l AIS in the final surgical specimen, Six of the 18 conizations (33%) had positive margins for AIS, Five of these patients (83%) were treate d with hysterectomy and one patient was treated with a repeat conizati on, Three of the five hysterectomy specimens as well as the repeat con ization specimen (67%) contained residual AIS. One conization (6%) had margins that could not be assessed, The absence of residual AIS in th e final surgical specimen was not predicted by the negative margin sta tus on the conization. (C) 1995 Academic Press, Inc.