Adenocarcinoma in situ of the uterine cervix: Clinical practice guidelines from the Italian society of colposcopy and cervical pathology (SICPCV)

Italian Society of Colposcopy and Cervico-Vaginal Pathology (SICPCV)

Research output: Contribution to journalReview article

Abstract

Objective: to provide a practical tool for the evidenced-based management of adenocarcinoma in situ (AIS) of the uterine cervix, a challenging diagnosis encountered by colposcopists in their daily practice. Methods: the proposed recommendations were drafted by the Italian Society of Colposcopy and Cervical Pathology (SICPCV) based on comprehensive reviews of previous guidelines, large uncontrolled studies, metanalysis, and sytematic reviews. The quality Level and the strength of the recommendations were graded and respectively expressed in Roman numbers (I–VI) and letters (A–E). Results: Women with all subcategories of abnormal glandular cells and AIS on cervical citology should be offered colposcopy with endocervical sampling (Strength of recommendation: A). In women with cytological AIS and negative colposcopy or endocervical curettage, an excisional treatment under colposcopic guidance is recommended (Strength of recommendation: A). If immediate post-conization endocervical sampling is positive, further conization is indicated (Strength of recommendation: C). In women who desire to preserve fertility with positive cone margins, further conization should be performed (Strength of recommendation: B). If colposcopy is adequate, a cylindrical excision that includes the whole transformation zone and at least 1–1.5 cm of endocervix beyond the squamous-columnar junction should be performed (Strength of recommendation: B). If colposcopy is inadequate, it is recommended that conization includes the whole transformation zone with a depth of 20–25 mm (Strength of recommendation: B). Hysterectomy is the standard definitive treatment for AIS in women who do not wish to preserve fertility (Strength of recommendation: B). Conclusion: the proposed recommendations should enable clinicians to correctly diagnose, treat and follow AIS patients, avoiding mismanagement.

Original languageEnglish (US)
Pages (from-to)273-277
Number of pages5
JournalEuropean Journal of Obstetrics and Gynecology and Reproductive Biology
Volume240
DOIs
StatePublished - Sep 1 2019

Fingerprint

Colposcopy
Conization
Practice Guidelines
Cervix Uteri
Pathology
Fertility
Curettage
Hysterectomy
Adenocarcinoma in Situ
Guidelines
Therapeutics

Keywords

  • Adenocarcinoma in situ
  • AIS
  • Cervix
  • Guidelines
  • SICPCV

ASJC Scopus subject areas

  • Reproductive Medicine
  • Obstetrics and Gynecology

Cite this

Adenocarcinoma in situ of the uterine cervix : Clinical practice guidelines from the Italian society of colposcopy and cervical pathology (SICPCV). / Italian Society of Colposcopy and Cervico-Vaginal Pathology (SICPCV).

In: European Journal of Obstetrics and Gynecology and Reproductive Biology, Vol. 240, 01.09.2019, p. 273-277.

Research output: Contribution to journalReview article

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abstract = "Objective: to provide a practical tool for the evidenced-based management of adenocarcinoma in situ (AIS) of the uterine cervix, a challenging diagnosis encountered by colposcopists in their daily practice. Methods: the proposed recommendations were drafted by the Italian Society of Colposcopy and Cervical Pathology (SICPCV) based on comprehensive reviews of previous guidelines, large uncontrolled studies, metanalysis, and sytematic reviews. The quality Level and the strength of the recommendations were graded and respectively expressed in Roman numbers (I–VI) and letters (A–E). Results: Women with all subcategories of abnormal glandular cells and AIS on cervical citology should be offered colposcopy with endocervical sampling (Strength of recommendation: A). In women with cytological AIS and negative colposcopy or endocervical curettage, an excisional treatment under colposcopic guidance is recommended (Strength of recommendation: A). If immediate post-conization endocervical sampling is positive, further conization is indicated (Strength of recommendation: C). In women who desire to preserve fertility with positive cone margins, further conization should be performed (Strength of recommendation: B). If colposcopy is adequate, a cylindrical excision that includes the whole transformation zone and at least 1–1.5 cm of endocervix beyond the squamous-columnar junction should be performed (Strength of recommendation: B). If colposcopy is inadequate, it is recommended that conization includes the whole transformation zone with a depth of 20–25 mm (Strength of recommendation: B). Hysterectomy is the standard definitive treatment for AIS in women who do not wish to preserve fertility (Strength of recommendation: B). Conclusion: the proposed recommendations should enable clinicians to correctly diagnose, treat and follow AIS patients, avoiding mismanagement.",
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author = "{Italian Society of Colposcopy and Cervico-Vaginal Pathology (SICPCV)} and Andrea Ciavattini and Luca Giannella and {Delli Carpini}, Giovanni and Dimitrios Tsiroglou and Francesco Sopracordevole and Giuseppe Chiossi and {Di Giuseppe}, Jacopo",
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AU - Ciavattini, Andrea

AU - Giannella, Luca

AU - Delli Carpini, Giovanni

AU - Tsiroglou, Dimitrios

AU - Sopracordevole, Francesco

AU - Chiossi, Giuseppe

AU - Di Giuseppe, Jacopo

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