[Follow-up studies after incomplete excision of cervical carcinoma in situ]

To understand the biological nature and the treatment of cervical carcinoma in situ (CIS), numerous (216) incompletely excised specimens obtained by conization at Auckland University's National Women's Hospital were examined and the histological findings with long-term follow-up were correlated. Follow-up studies were possible in 211 patients for two years or more; 88.4% were followed up for at least five years. There was no evidence of recurrence in 62.9% of the total series. Recurrences were related to the area of CIS in the cervix, and the incompletely excised sites and blocks. Micro-invasive carcinoma was found in four patients (1.90%) and invasive carcinoma (stage Ib "occ") in two (0.95%). The following conclusion has been drawn: If CIS is incompletely excised by conization, follow-up examinations are essential. When the CIS is small in the cervix or it is incompletely excised only outside the endocervix, spontaneous disappearance can be expected. In the entire series, including patients in whom the incomplete excision left a fairly large CIS remnant, the nonrecurrence rate was unexpectedly high. These findings suggest that the continued existence of incompletely excised CIS is significantly inhibited by a considerable damage to the conization.