[The diagnosis, management and treatment results in patients with carcinoma in situ of the cervix uteri]

Abstract

The authors analysed the results of 225 women with carcinoma of the uterine cervix, treated at the gynecological clinic of the National Oncological Center for a 10-year period. The mean age was 36.7 years. No complaints were found in 206 patients. Cytological Pap 3-5 was established in 221 women. Conformity between histological examination after a colposcopic-directed biopsy, conization or total hysterectomy was found in 117 patients (53.18%). Carcinoma was discovered at 0 degree in 34 patients (11.44%) only just after conization, but in 69 women the tumour was removed during a colposcopic-directed biopsy and was not found in the operation material. Treatment of 217 women was conization, of 3 women--classical total hysterectomy and of 5 patients--intracavitary brachytherapy. In 7 patients the tumour was not removed till healthy tissue, which caused reconization in one woman and total hysterectomy in 6 patients. A relapse of the disease was found in 9 patients up to 2 years after conization (6 cases with carcinoma in situ, 3--with microinvasive carcinoma). Total hysterectomy was performed in all patients. Possibility for discovery of a relapse in the form of invasive carcinoma is ruled out during systemic and continuous observation. It is possible to perform reconization in women with persistent carcinoma in situ in view of preserving their generative function.