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Long-Term Surveillance Is Required for All Women Treated for Cervical Adenocarcinoma In Situ

Hwang, David M. MD, PhD1,3; Lickrish, Gordon M. MD, ChB2,3; Chapman, William MD1,3; Colgan, Terence J. MD1,4

Journal of Lower Genital Tract Disease: April 2004 - Volume 8 - Issue 2 - p 125-131

Objective. To measure the recurrence rate of disease in women treated for cervical adenocarcinoma in situ (ACIS) by either hysterectomy or conservative surgical management.

Patients and Methods. One hundred patients with a histopathologic diagnosis of ACIS or glandular dysplasia were identified in a retrospective clinicopathological review. Sixty-seven of the 100 patients were managed conservatively by local excision and were followed up for a mean period of 59 months (range, 1–222 months). The remaining 33 patients underwent hysterectomy as the primary management method and were followed up for a mean of 88 months (range, 1–248 months). If there was histologic documentation of ACIS or invasive adenocarcinoma more than 1 year after treatment, this was considered a recurrence.

Results. A total of four recurrences were noted in the 100 patients, three in the conservatively managed group and one in the hysterectomy group. Two late recurrences were noted at 97 and 153 months, one each in the conservatively managed and hysterectomy groups.

Conclusions. Women who have been treated for cervical ACIS require long-term surveillance for at least 10 years regardless of whether they have undergone hysterectomy or conservative management.

Long-term surveillance is recommended for all women treated for cervical adenocarcinoma in situ by either hysterectomy or conservative local excision.

1Departments of Laboratory Medicine and Pathobiology and 2Obstetrics and Gynecology, University of Toronto, 3University Health Network (Princess Margaret Hospital), and 4Mount Sinai Hospital, Toronto, Ontario, Canada

Correspondence to: Terence J. Colgan, MD, Department of Pathology and Laboratory Medicine, Mount Sinai Hospital, 600 University Avenue, Toronto, Ontario, Canada, M5G 1X5. E-mail:

©2004The American Society for Colposcopy and Cervical Pathology