Adenocarcinoma in situ of the uterine cervix: a metaanalysis of 1278 patients evaluating the predictive value of conization margin status

Ritu Salani, Isha Puri, Robert E. Bristow

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: We sought to determine the value of conization margin status in predicting residual and recurrent adenocarcinoma in situ (ACIS) of the cervix. Study Design: In all, 33 studies (1278 patients) were identified. Metaanalysis with pooled Mantel-Haenszel odds ratio (OR) was used to compare the risk of residual and recurrent disease according to margin status. Results: A repeated excisional procedure was performed in 607 patients; a positive conization margin was associated with a significant increase in the risk of residual disease (OR, 4.01; 95% confidence interval [CI], 2.62-6.33; P < .001). Of the 671 patients followed up with surveillance only, 2.6% with negative margins and 19.4% with positive margins developed a recurrence (OR, 2.48; 95% CI, 1.05-6.22; P < .001). Invasive adenocarcinoma was more commonly associated with positive margins (5.2%) compared with negative margins (0.1%). Conclusion: After conization for ACIS, patients with positive margins are significantly more likely to have residual or recurrent disease, whereas those with negative margins may be treated conservatively.

Original languageEnglish (US)
Pages (from-to)182.e1-182.e5
JournalAmerican journal of obstetrics and gynecology
Volume200
Issue number2
DOIs
StatePublished - Feb 2008

Keywords

  • adenocarcinoma in situ of the cervix
  • cervical conization
  • conization margins

ASJC Scopus subject areas

  • Obstetrics and Gynecology

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