Cervical Carcinoma in situ after Incomplete Conisation

Abstract

To investigate further the nature and treatment of cervical carcinoma in situ (CIS), 211 conisation specimens reported as showing “incomplete excision of CIS,” obtained at Auckland University's National Women's Hospital were examined and the histological findings correlated with long-term follow-up (2 to 16 years); 88.4% were followed for at least 5 years.

There was persistence or recurrence in 34.1% of the total. Recurrence was related to the extent of CIS in the cervix, as judged from the incompletely excised sites and remaining tissue blocks. Micro-invasive carcinoma was found in 4 patients (1.9%) and invasive carcinoma (Stage Ib “occ”) in 2 (0.9%). It was concluded that when the CIS is small in extent in the cervix, or is incompletely excised only at the exocervix, spontaneous disappearance of any remainder can be expected. The findings suggest that the continued existence of incompletely excised CIS is significantly inhibited by the healing process.