Modalités et limites du traitement conservateur des adénocarcinomes in situ du col utérin: Analyse de neuf cas et revue de la littérature

Objective. - The aim of this study is to assess the results of conservative management of adenocarcinoma in situ (AIS) of the uterine cervix in young patients. Patients and methods. - Data of 16 patients treated for AIS were reviewed: 10 were treated initially conservatively (cold knife conization in five patients, loop excision in three patients and cervical amputation in two patients) and six radically. One patient treated initially conservatively with loop excision and positive margins underwent a completion surgery (hysterectomy). Results. - None patient had recurrence whatever the type of surgery (radical or conservative) with a mean follow-up of 74 months. Two pregnancies were observed. Discussion and conclusions. - Conservative surgery for patients with AIS could be considered in young patients. But {for} reviewing literature several conditions should be respected: careful follow-up after conservative treatment; cold knife conization; length of cone specimen >25 mm and free margins, If those criteria are respected the risk of recurrent disease under the form of invasive carcinoma is low.