Management of in situ cervical adenocarcinoma

The management of adenocarcinoma in situ of the cervix (ACIS) is difficult because it is often diagnosed in younger women who may wish to preserve their potential of fertility. Conservative treatment has been accepted as an appropriate strategy but interrogations persist as to carcinological safety....

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Bibliographic Details
Published in:Gynécologie, obstétrique & fertilité obstétrique & fertilité, 2006-12, Vol.34 (12), p.1178-1184
Main Authors: Graesslin, O, Dedecker, F, Collinet, P, Jouve, E, Urbaniack, D, Leroy, J-L, Boulanger, J-C, Quéreux, C
Format: Article
Language:fre
Subjects:
Adenocarcinoma - surgery
Carcinoma in Situ - surgery
Colposcopy - methods
Female
Humans
Hysterectomy - methods
Neoplasm Recurrence, Local - prevention & control
Neoplasm Recurrence, Local - surgery
Reproduction - physiology
Uterine Cervical Neoplasms - surgery
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Summary:The management of adenocarcinoma in situ of the cervix (ACIS) is difficult because it is often diagnosed in younger women who may wish to preserve their potential of fertility. Conservative treatment has been accepted as an appropriate strategy but interrogations persist as to carcinological safety. We report a complete review of the literature on this subject where conservative attitude appears possible but is associated with recurrence risk (5 to 10%) and invasive disease (2%). Conditions to perform conservative management are: cold knife cone biopsy, negative margins, cone resection of at least 25 mm, realization of endocervical curettage and total patient compliance. In all cases, regular cytological and histological monitoring must be performed. If maintaining reproductive capacity is not desired, hysterectomy is systematically proposed to patient.
ISSN:1297-9589