Endocervical curettage at conization to predict residual cervical adenocarcinoma in situ

Jayanthi S. Lea, Christine H. Shin, Ellen E. Sheets, Robert L. Coleman, Paola A. Gehrig, Linda R. Duska, David S. Miller, John O. Schorge

Research output: Contribution to journalArticle

47 Scopus citations

Abstract

Objective. To determine if performing an endocervical curettage (ECC) at the time of conization is a useful diagnostic tool for predicting residual cervical adenocarcinoma in situ (AIS) among women who might wish to preserve their fertility. Methods. All patients diagnosed with AIS from 1995 to 2000 at four institutions were identified. Data were retrospectively extracted from clinical records. Women included in the statistical analysis were (1) younger than 40 years, (2) had an ECC performed at the time of the initial cone biopsy, (3) had a clearly demarcated surgical margin pathologically, and (4) underwent a second surgical procedure. Results. Twenty-nine (24%) of 123 AIS patients met criteria for inclusion. The median age was 33 years (range, 17 to 39) and 13 (46%) were nulliparous. Initial surgery was a cold-knife conization (3 = 17) or loop electrosurgical excision procedure (n = 12). Twelve (41%) ECCs and 15 (52%) cone margins were histologically positive. Sixteen patients underwent a repeat conization; 13 underwent hysterectomy. Thirteen (45%) patients had residual AIS at the time of their second surgical procedure. ECC had a superior positive predictive value (100% vs 47%; P < 0.01) and negative predictive value (94% vs 57%; P = 0.01) compared to cone margin in predicting residual AIS. None of the women undergoing fertility-sparing surgery developed recurrent AIS or adenocarcinoma. Conclusion. ECC performed at the time of conization may be a useful tool for predicting residual AIS in women considering fertility preservation.

Original languageEnglish (US)
Pages (from-to)129-132
Number of pages4
JournalGynecologic oncology
Volume87
Issue number1
DOIs
StatePublished - Jan 1 2002

Keywords

  • Cervical adenocarcinoma
  • Endocervical curettage
  • Uterine preservation

ASJC Scopus subject areas

  • Oncology
  • Obstetrics and Gynecology

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    Lea, J. S., Shin, C. H., Sheets, E. E., Coleman, R. L., Gehrig, P. A., Duska, L. R., Miller, D. S., & Schorge, J. O. (2002). Endocervical curettage at conization to predict residual cervical adenocarcinoma in situ. Gynecologic oncology, 87(1), 129-132. https://doi.org/10.1006/gyno.2002.6791