ORIGINAL RESEARCH article
Front. Oncol.
Sec. Gynecological Oncology
Volume 15 - 2025 | doi: 10.3389/fonc.2025.1571130
CIN coexisting with AIS is a risk factor for residual disease after conization for cervical adenocarcinoma in situ
Provisionally accepted
- 1Hubei Cancer Hospital, Wuhan, China
- 2Department of Gynecologic Oncology, Hubei Cancer Hospital, Wuhan, China
- 3Cervical Cancer Control Center of Hubei Province. Maternal and Childe Health Hospital of Hubei Province, Wuhan, China
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Introduction: Compared to definitive hysterectomy, cervical conization with negative margin remains a controversial management for AIS currently. Our study aimed to evaluate: 1) the effect of conization with negative margin alone or subsequent hysterectomy; 2) the effect of LEEP and CKC with or without subsequent hysterectomy; 3) the correlation between clinicopathologic characteristics and residual disease after conization.Methods: This retrospective study involved 59 AIS patients who had negative margins through conization, with or without subsequent hysterectomy, focusing on clinicopathologic characteristics and outcomes.Results: 59 patients with the median age of 34yrs were followed for 3~95 months (median follow-up period: 35m). 20 patients underwent subsequent hysterectomy (Hysterectomy group) and 39 patients underwent conization alone (Conization group). 24 patients obtained negative margin through LEEP (LEEP group) and 35 patients through CKC (CKC group). Firstly, no significant difference in the rate of disease recurrence (2.6% vs 0%, P-value=1.0), HR-HPV positivity at first follow-up (15.4% vs 5.0%, P-value=0.404) or HR-HPV clearance (84.6% vs 95.0%, P-value=0.404) was found between Conization and Hysterectomy group. Secondly, no significant difference in the rate of disease recurrence (0% vs 2.6%, P-value=1.0), HR-HPV positivity at first follow-up (8.3% vs 10.3%, P-value=0.689) or HR-HPV clearance (91.7% vs 89.7%, P-value=0.689) was found between CKC and LEEP group . Lastly, 5 patients (25.0%) with residual disease were found in Hysterectomy group. All 5 patients were CIN coexisting with AIS (AIS-plus-CIN), and AIS-plus-CIN was identified as an independent risk for residual disease after conization (HR 3.64, 95% CI: 1.01-4.26, P-value=0.027). Moreover, one patient developing recurrent disease was AIS–plus–CIN in Conization group.Discussion: Either CKC or LEEP with negative margin could achieve equivalent effect compared with subsequent hysterectomy and could be recommended as an alternative therapy for AIS. However, subsequent hysterectomy is advised for AIS-plus-CIN.
Keywords: AIS, AIS-plus-CIN, Hysterectomy, Residual disease activity, Conization, Negative margin
Received: 05 Feb 2025; Accepted: 12 May 2025.
Copyright: © 2025 Zeng, Guo, Zou, Wang and Wu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Xufeng Wu, Cervical Cancer Control Center of Hubei Province. Maternal and Childe Health Hospital of Hubei Province, Wuhan, China
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