Risk of persistent and recurrent cervical neoplasia following incidentally detected adenocarcinoma-in-situ.
BACKGROUND: Adenocarcinoma-in-situ (AIS) of the uterine cervix is a precursor to cervical adenocarcinoma and may co-exist with both adenocarcinoma and high-grade squamous dysplasia (cervical intraepithelial neoplasia (CIN) 2 and 3). Up to 60% of AIS lesions are detected incidentally following excisi...
| Main Authors: | , , , , , , , , , , , , |
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| Format: | Journal Article |
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Mosby, Inc.
2017
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| Online Access: | http://hdl.handle.net/20.500.11937/32071 |
| _version_ | 1848753560502665216 |
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| author | Munro, A. Codde, J. Spilsbury, Katrina Steel, N. Stewart, C. Salfinger, S. Tan, J. Mohan, G. Leung, Y. Semmens, James O'Leary, Peter Williams, Vincent Cohen, P. |
| author_facet | Munro, A. Codde, J. Spilsbury, Katrina Steel, N. Stewart, C. Salfinger, S. Tan, J. Mohan, G. Leung, Y. Semmens, James O'Leary, Peter Williams, Vincent Cohen, P. |
| author_sort | Munro, A. |
| building | Curtin Institutional Repository |
| collection | Online Access |
| description | BACKGROUND: Adenocarcinoma-in-situ (AIS) of the uterine cervix is a precursor to cervical adenocarcinoma and may co-exist with both adenocarcinoma and high-grade squamous dysplasia (cervical intraepithelial neoplasia (CIN) 2 and 3). Up to 60% of AIS lesions are detected incidentally following excisional biopsies performed for the treatment of CIN 2/3. To date there are no data regarding risk factors for persisting or progressive cervical neoplasia in these patients. OBJECTIVE: To investigate patient outcomes following incidentally detected cervical AIS after loop electrosurgical excision procedure (LEEP) or cold knife cone (CKC) biopsy performed for the treatment of high-grade cervical intraepithelial neoplasia (CIN). STUDY DESIGN: A retrospective, population-based cohort study of Western Australian patients with an incidental diagnosis of AIS between 2001 and 2012. Primary outcomes were persistent or recurrent CIN 2/3 and or AIS, and invasive adenocarcinoma during follow-up (<12 months) and surveillance (=12 months) periods. RESULTS: The cohort comprised 298 patients, with 228 (76.5%) treated initially by LEEP and 70 (23.5%) treated by CKC biopsy. The mean age was 31.2 years (range 18 to 68 years) and the median length of follow-up was 2.4 years (range 0.3 to 12.2 years). Overall, 11 (3.7%) patients had CIN 2/3, 23 (7.7%) had AIS and 3 (1.0%) had adenocarcinoma diagnosed during the follow-up and surveillance periods. Age over 30 years, pure AIS lesions and larger lesions (>8mm) were associated with a greater risk of disease persistence or recurrence. CONCLUSION(S): Following the incidental detection of AIS, age >30 years, pure AIS lesions and lesions >8mm, were significantly associated with disease persistence/recurrence. In younger women, incidentally detected AIS which co-exists with CIN 2/3 and is <8mm extent with clear margins may not require re-excision. |
| first_indexed | 2025-11-14T08:26:27Z |
| format | Journal Article |
| id | curtin-20.500.11937-32071 |
| institution | Curtin University Malaysia |
| institution_category | Local University |
| last_indexed | 2025-11-14T08:26:27Z |
| publishDate | 2017 |
| publisher | Mosby, Inc. |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | curtin-20.500.11937-320712017-12-05T04:30:34Z Risk of persistent and recurrent cervical neoplasia following incidentally detected adenocarcinoma-in-situ. Munro, A. Codde, J. Spilsbury, Katrina Steel, N. Stewart, C. Salfinger, S. Tan, J. Mohan, G. Leung, Y. Semmens, James O'Leary, Peter Williams, Vincent Cohen, P. BACKGROUND: Adenocarcinoma-in-situ (AIS) of the uterine cervix is a precursor to cervical adenocarcinoma and may co-exist with both adenocarcinoma and high-grade squamous dysplasia (cervical intraepithelial neoplasia (CIN) 2 and 3). Up to 60% of AIS lesions are detected incidentally following excisional biopsies performed for the treatment of CIN 2/3. To date there are no data regarding risk factors for persisting or progressive cervical neoplasia in these patients. OBJECTIVE: To investigate patient outcomes following incidentally detected cervical AIS after loop electrosurgical excision procedure (LEEP) or cold knife cone (CKC) biopsy performed for the treatment of high-grade cervical intraepithelial neoplasia (CIN). STUDY DESIGN: A retrospective, population-based cohort study of Western Australian patients with an incidental diagnosis of AIS between 2001 and 2012. Primary outcomes were persistent or recurrent CIN 2/3 and or AIS, and invasive adenocarcinoma during follow-up (<12 months) and surveillance (=12 months) periods. RESULTS: The cohort comprised 298 patients, with 228 (76.5%) treated initially by LEEP and 70 (23.5%) treated by CKC biopsy. The mean age was 31.2 years (range 18 to 68 years) and the median length of follow-up was 2.4 years (range 0.3 to 12.2 years). Overall, 11 (3.7%) patients had CIN 2/3, 23 (7.7%) had AIS and 3 (1.0%) had adenocarcinoma diagnosed during the follow-up and surveillance periods. Age over 30 years, pure AIS lesions and larger lesions (>8mm) were associated with a greater risk of disease persistence or recurrence. CONCLUSION(S): Following the incidental detection of AIS, age >30 years, pure AIS lesions and lesions >8mm, were significantly associated with disease persistence/recurrence. In younger women, incidentally detected AIS which co-exists with CIN 2/3 and is <8mm extent with clear margins may not require re-excision. 2017 Journal Article http://hdl.handle.net/20.500.11937/32071 10.1016/j.ajog.2016.11.1044 Mosby, Inc. fulltext |
| spellingShingle | Munro, A. Codde, J. Spilsbury, Katrina Steel, N. Stewart, C. Salfinger, S. Tan, J. Mohan, G. Leung, Y. Semmens, James O'Leary, Peter Williams, Vincent Cohen, P. Risk of persistent and recurrent cervical neoplasia following incidentally detected adenocarcinoma-in-situ. |
| title | Risk of persistent and recurrent cervical neoplasia following incidentally detected adenocarcinoma-in-situ. |
| title_full | Risk of persistent and recurrent cervical neoplasia following incidentally detected adenocarcinoma-in-situ. |
| title_fullStr | Risk of persistent and recurrent cervical neoplasia following incidentally detected adenocarcinoma-in-situ. |
| title_full_unstemmed | Risk of persistent and recurrent cervical neoplasia following incidentally detected adenocarcinoma-in-situ. |
| title_short | Risk of persistent and recurrent cervical neoplasia following incidentally detected adenocarcinoma-in-situ. |
| title_sort | risk of persistent and recurrent cervical neoplasia following incidentally detected adenocarcinoma-in-situ. |
| url | http://hdl.handle.net/20.500.11937/32071 |