[On the therapy of uterine cervix carcinoma in situ]

It is reported of 607 cases of uterine cervix carcinoma in situ from the years 1963 to 1977. During this period, the diagnostic and therapeutic procedures as well as the histological preparation technique have advanced. -- 75% of the cases were primarily conized. About half of these cases were surely radically excised. 323 patients (53,2%) were treated actively by simple hysterectomy, 242 patients (46,8%) were treated conservatively (190 conisations, 19 reconisations, 60 portioamputations, 12 ringbiopsies, 3 radiations). -- After 323 total exstirpations, 2 recurrences of carcinoma in situ in vaginal stump were observed (0,6%). After local treatment of 242 patients, 17 recurrences of the disease appeared (6%), among them 4 cases as invasive cervix carcinoma. 11 cases belong to the group of primarily nonexcised or uncertainly radically excised carcinoma in situ, and in 4 cases a possibility of recurrence has been discussed. -- It has been refered to the importance of the exact conisation technique and subtile histotechnical obtaining of slides in step sections. If the carcinoma in situ radically excised and followed by an attentive follow up in women below 40 years, a conservative procedure is adviced. For women above 40 years an active procedure is indicated, because it offers a high therapeutic reliability and a minimal risk. For cases of nonradically excised carcinoma in situ hysterectomy is indicated. The removal of the vaginal cuff is considered as unnecessary.