Risk for Residual Adenocarcinoma in Situ or Cervical Adenocarcinoma in Women Undergoing Loop Electrosurgical Excision Procedure/Conization for Adenocarcinoma in Situ

OBJECTIVE: To evaluate the risk for residual adenocarcinoma in situ (AIS) or cervical adenocarcinoma in wornen undergoing loop electrosurgical excision procedure (LEEP)/conization as the initial management for AIS. STUDY DESIGN: A retrospective chart study was conducted from 1990 to 2005. Patients with AIS were identified from a pathology database. RESULTS: Forty-three patients were identified with AIS of the cervix who were initially treated with LEEP/conization. Twelve cases of invasive adenocarcinoma (28%) were identified on LEEP/conization. Margin status was available for 41 patients. Twenty (49%) patients had a positive margin, and 21(51%) patients had a negative margin. Nineteen women with positive margins underwent definitive surgical therapy; 68% had residual AIS. Eleven women with negative margins underwent hysterectomy; 45% had residual AIS. Women with positive and negative margins were compared and found to differ significantly in regard to diagnosis of adeno-carcinoma on LEEP/conization. CONCLUSION: Women status post-LEEP/conization for AIS have a high risk of residual AIS, even with negative conization margins. If definitive hysterectomy is deffered, close follow-up is mandatory. (J Reprod Med 2011;56:376-380)