Management of Carcinoma in situ of the Uterine Cervix by Selective Local Excision

Abstract

Local excision of severe dysplasia or carcinoma in situ of the uterine cervix by punch biopsies was the treatment in 366 cases. In 61%, cervical cytology reverted to negative or slight atypia; 153 patients were followed from 1-7 yr. Failures to remove the entire lesion were discovered within the 1st yr of follow-up in all cases but 10. Complications were negligible and no patients subsequently developed invasive cancer of the cervix. Selective local excision as an alternative to other minimally traumatic techniques, e.g., cyrotherapy was discussed. Although the failure rate was slightly higher with local excision, an obvious advantage was the availability of all removed tissue for histopathologic diagnosis. The risk of overlooking microinvasive disease was reduced to a minimum.