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 journalArticle

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)
JournalAmerican Journal of Obstetrics and Gynecology
Volume200
Issue number2
DOIs
StatePublished - Feb 2008

Fingerprint

Conization
Cervix Uteri
Odds Ratio
Confidence Intervals
Adenocarcinoma
Recurrence
Adenocarcinoma in Situ

Keywords

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

ASJC Scopus subject areas

  • Obstetrics and Gynecology

Cite this

Adenocarcinoma in situ of the uterine cervix : a metaanalysis of 1278 patients evaluating the predictive value of conization margin status. / Salani, Ritu; Puri, Isha; Bristow, Robert E.

In: American Journal of Obstetrics and Gynecology, Vol. 200, No. 2, 02.2008.

Research output: Contribution to journalArticle

@article{b44b0767c9e740e8bc4e0b865c61efe6,
title = "Adenocarcinoma in situ of the uterine cervix: a metaanalysis of 1278 patients evaluating the predictive value of conization margin status",
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.",
keywords = "adenocarcinoma in situ of the cervix, cervical conization, conization margins",
author = "Ritu Salani and Isha Puri and Bristow, {Robert E.}",
year = "2008",
month = "2",
doi = "10.1016/j.ajog.2008.09.012",
language = "English (US)",
volume = "200",
journal = "American Journal of Obstetrics and Gynecology",
issn = "0002-9378",
publisher = "Mosby Inc.",
number = "2",

}

TY - JOUR

T1 - Adenocarcinoma in situ of the uterine cervix

T2 - a metaanalysis of 1278 patients evaluating the predictive value of conization margin status

AU - Salani, Ritu

AU - Puri, Isha

AU - Bristow, Robert E.

PY - 2008/2

Y1 - 2008/2

N2 - 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.

AB - 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.

KW - adenocarcinoma in situ of the cervix

KW - cervical conization

KW - conization margins

UR - http://www.scopus.com/inward/record.url?scp=58749094805&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=58749094805&partnerID=8YFLogxK

U2 - 10.1016/j.ajog.2008.09.012

DO - 10.1016/j.ajog.2008.09.012

M3 - Article

C2 - 19019325

AN - SCOPUS:58749094805

VL - 200

JO - American Journal of Obstetrics and Gynecology

JF - American Journal of Obstetrics and Gynecology

SN - 0002-9378

IS - 2

ER -