{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,27]],"date-time":"2026-01-27T21:59:57Z","timestamp":1769551197224,"version":"3.49.0"},"reference-count":18,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2019,10,3]],"date-time":"2019-10-03T00:00:00Z","timestamp":1570060800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Aust NZ J Obst Gynaeco"],"published-print":{"date-parts":[[2020,2]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Adenocarcinoma <jats:italic>in situ<\/jats:italic> of cervix is increasingly managed by local excision rather than hysterectomy and this study will ascertain if conservative management by excision alone is adequate.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>To evaluate the long\u2010term outcomes of conservative management of adenocarcinoma <jats:italic>in situ<\/jats:italic> of cervix, particularly in relation to excisional margin status.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and Methods<\/jats:title><jats:p>Retrospective analysis of women diagnosed with adenocarcinoma <jats:italic>in situ<\/jats:italic> and their management between 1992 and 2010 retrieved from the Victorian Cervical Cytology Registry, Australia. Failure of conservative treatment is defined by histologically proven adenocarcinoma <jats:italic>in situ<\/jats:italic> or adenocarcinoma at follow\u2010up after negative excisional margins.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>adenocarcinoma <jats:italic>in situ<\/jats:italic> of the cervix was managed primarily with cold knife cone biopsy or loop electrosurgical excision of the cervix. Most excisions were in one piece (83.4%) with average depth of 16.1\u00a0mm and 21.9% had involved excisional margins. Women with adenocarcinoma <jats:italic>in situ<\/jats:italic> on any excisional margin were more likely to have residual or recurrent disease (28.7%) compared with negative excisional margins (4.3%). Residual adenocarcinoma <jats:italic>in situ<\/jats:italic> was twice as common if adenocarcinoma <jats:italic>in situ<\/jats:italic> was present at endocervical (29.6%) and stromal (23.1%) margins compared with an ectocervical margin (13.6%). Cancer incidence at follow\u2010up was 2.3% for women with positive excisional margins compared to 1.3% with negative margins.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Women with adenocarcinoma <jats:italic>in situ<\/jats:italic> of cervix can be managed with local excisional procedures, best in single pieces to provide the important information on excisional margins. Adenocarcinoma <jats:italic>in situ<\/jats:italic> at endocervical and stromal excisional margins needs re\u2010excision or where appropriate, hysterectomy, while negative excisional margins have a low rate of recurrence and can be followed up with test of cure.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ajo.13047","type":"journal-article","created":{"date-parts":[[2019,10,3]],"date-time":"2019-10-03T07:28:12Z","timestamp":1570087692000},"page":"123-129","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Management and long\u2010term outcomes of women with adenocarcinoma <i>in situ<\/i> of the cervix: A retrospective study"],"prefix":"10.1111","volume":"60","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0226-8647","authenticated-orcid":false,"given":"Jeffrey H.J.","family":"Tan","sequence":"first","affiliation":[{"name":"Department of Oncology &amp; Dysplasia The Royal Women's Hospital Melbourne Victoria Australia"},{"name":"Department of Obstetrics and Gynaecology University of Melbourne Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael J.","family":"Malloy","sequence":"additional","affiliation":[{"name":"Victorian Cervical Cytology Registry Melbourne Victoria Australia"},{"name":"School of Population and Global Health University of Melbourne Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ramaish","family":"Thangamani","sequence":"additional","affiliation":[{"name":"Department of Oncology &amp; Dysplasia The Royal Women's Hospital Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dorota","family":"Gertig","sequence":"additional","affiliation":[{"name":"School of Population and Global Health University of Melbourne Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kelly T.","family":"Drennan","sequence":"additional","affiliation":[{"name":"Victorian Cervical Cytology Registry Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C. David","family":"Wrede","sequence":"additional","affiliation":[{"name":"Department of Oncology &amp; Dysplasia The Royal Women's Hospital Melbourne Victoria Australia"},{"name":"Department of Obstetrics and Gynaecology University of Melbourne Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marion","family":"Saville","sequence":"additional","affiliation":[{"name":"Victorian Cytology Service Ltd Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Quinn","sequence":"additional","affiliation":[{"name":"Department of Oncology &amp; Dysplasia The Royal Women's Hospital Melbourne Victoria Australia"},{"name":"Department of Obstetrics and Gynaecology University of Melbourne Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2019,10,3]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9378(16)38860-3"},{"key":"e_1_2_8_3_1","unstructured":"VCCR Statistical report 2001\u20132010. [Cited 19 Aug 2019.] Available from URL:https:\/\/www.vcs.org.au\/population-health\/statistical-reports\/"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.3802\/jgo.2011.22.1.25"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygyno.2007.06.021"},{"issue":"6","key":"e_1_2_8_6_1","first-page":"641","article-title":"Clinical outcomes of patients with adenocarcinoma in situ treated by conization","volume":"35","author":"Taylor JS","year":"2014","journal-title":"Eur J Gynaecol Oncol"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1006\/gyno.2000.5957"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/00128360-200404000-00008"},{"key":"e_1_2_8_9_1","unstructured":"NHMRC (National Health and Medical Research Council).Screening to prevent cervical cancer: guidelines for the management of asymptomatic women with screen\u2010detected abnormalities.Canberra ACT:NHMRC 2005."},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/IGC.0000000000000260"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygyno.2015.02.024"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2008.09.012"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2003.00277.x"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1006\/gyno.1999.5395"},{"key":"e_1_2_8_15_1","first-page":"376","article-title":"Risk for residual adenocarcinoma in situ or cervical adenocarcinoma in women undergoing loop electrosurgical excision procedure\/conisation for adenocarcinoma in situ","volume":"56","author":"DeSimone CP","year":"2011","journal-title":"J Reprod Med"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2013.12.030"},{"key":"e_1_2_8_17_1","unstructured":"UK NHS Cervical Screening Program. [Cited 19 Aug 2019.] Available from URL:https:\/\/www.gov.uk\/government\/uploads\/system\/uploads\/attachment_data\/file\/515817\/NHSCSP_colposcopy_management.pdf"},{"key":"e_1_2_8_18_1","unstructured":"National Cervical Screening Program: Guidelines for the management of screen\u2010detected abnormalities screening in specific populations and investigation of abnormal vaginal bleeding. [Cited 19 Aug 2019.] Available from URL:https:\/\/wiki.cancer.org.au\/australia\/Guidelines:Cervical_cancer\/Screening"},{"key":"e_1_2_8_19_1","unstructured":"National Cancer Screening Register. [Cited 19 Aug 2019.] Available from URL:https:\/\/www.ncsr.gov.au\/"}],"container-title":["Australian and New Zealand Journal of Obstetrics and Gynaecology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ajo.13047","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/ajo.13047","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ajo.13047","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,6]],"date-time":"2023-09-06T16:31:03Z","timestamp":1694017863000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1111\/ajo.13047"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,10,3]]},"references-count":18,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2020,2]]}},"alternative-id":["10.1111\/ajo.13047"],"URL":"https:\/\/doi.org\/10.1111\/ajo.13047","archive":["Portico"],"relation":{},"ISSN":["0004-8666","1479-828X"],"issn-type":[{"value":"0004-8666","type":"print"},{"value":"1479-828X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,10,3]]},"assertion":[{"value":"2019-03-07","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-07-23","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-10-03","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}