Management of carcinoma in situ of the cervix

Sixty-eight patients with in situ and seven patients with microinvasive cervical carcinoma were reviewed. Thirty per cent of the patients with carcinoma in situ were 30 years old and under. The mean age for carcinoma in situ was 37.8 years; for microinvasion, 42.6 years; and for postconization residual carcinoma, 48.5 years. Forty per cent of the patients were para 0 or 1. There was a 13 per cent incidence of postconization complications. The incidence of residual carcinoma in 58 patients who underwent conization and subsequent hysterectomy was only 10.3 per cent. The residual carcinoma was present high in the endocervical canal of the hysterectomy specimen. None of the patients with microinvasion had residual carcinoma. A positive correlation was found between the anatomic extent of the lesion on the conization specimen and the incidence of residual carcinoma. We conclude that conization and careful follow-up frequently are effective therapy for treating cervical carcinoma in situ, thereby reducing the incidence of hysterectomy.