Cold knife versus laser cone biopsy for adenocarcinoma in situ of the cervix—a comparison of management and outcome

Authors

  • C. DALRYMPLE,

    Corresponding author
    1. *Sydney Gynaecologic Oncology Group, Sydney Cancer Centre, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia; †Division of Gynecologic Oncology, Ohio State University, Ohio; ‡Discipline of Obstetrics & Gynaecology, Central Clinical School, Faculty of Medicine, University of Sydney, New South Wales, Australia; and §Department of Anatomical Pathology, Royal Prince Alfred Hospital, Department of Pathology, University of Sydney, New South Wales, Australia
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  • S. VALMADRE,

    1. *Sydney Gynaecologic Oncology Group, Sydney Cancer Centre, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia; †Division of Gynecologic Oncology, Ohio State University, Ohio; ‡Discipline of Obstetrics & Gynaecology, Central Clinical School, Faculty of Medicine, University of Sydney, New South Wales, Australia; and §Department of Anatomical Pathology, Royal Prince Alfred Hospital, Department of Pathology, University of Sydney, New South Wales, Australia
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  • A. COOK,

    1. *Sydney Gynaecologic Oncology Group, Sydney Cancer Centre, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia; †Division of Gynecologic Oncology, Ohio State University, Ohio; ‡Discipline of Obstetrics & Gynaecology, Central Clinical School, Faculty of Medicine, University of Sydney, New South Wales, Australia; and §Department of Anatomical Pathology, Royal Prince Alfred Hospital, Department of Pathology, University of Sydney, New South Wales, Australia
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  • K. ATKINSON,

    1. *Sydney Gynaecologic Oncology Group, Sydney Cancer Centre, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia; †Division of Gynecologic Oncology, Ohio State University, Ohio; ‡Discipline of Obstetrics & Gynaecology, Central Clinical School, Faculty of Medicine, University of Sydney, New South Wales, Australia; and §Department of Anatomical Pathology, Royal Prince Alfred Hospital, Department of Pathology, University of Sydney, New South Wales, Australia
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  • J. CARTER,

    1. *Sydney Gynaecologic Oncology Group, Sydney Cancer Centre, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia; †Division of Gynecologic Oncology, Ohio State University, Ohio; ‡Discipline of Obstetrics & Gynaecology, Central Clinical School, Faculty of Medicine, University of Sydney, New South Wales, Australia; and §Department of Anatomical Pathology, Royal Prince Alfred Hospital, Department of Pathology, University of Sydney, New South Wales, Australia
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  • C.R.S. HOUGHTON,

    1. *Sydney Gynaecologic Oncology Group, Sydney Cancer Centre, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia; †Division of Gynecologic Oncology, Ohio State University, Ohio; ‡Discipline of Obstetrics & Gynaecology, Central Clinical School, Faculty of Medicine, University of Sydney, New South Wales, Australia; and §Department of Anatomical Pathology, Royal Prince Alfred Hospital, Department of Pathology, University of Sydney, New South Wales, Australia
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  • P. RUSSELL

    1. *Sydney Gynaecologic Oncology Group, Sydney Cancer Centre, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia; †Division of Gynecologic Oncology, Ohio State University, Ohio; ‡Discipline of Obstetrics & Gynaecology, Central Clinical School, Faculty of Medicine, University of Sydney, New South Wales, Australia; and §Department of Anatomical Pathology, Royal Prince Alfred Hospital, Department of Pathology, University of Sydney, New South Wales, Australia
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Chris Dalrymple, MB, BS, FRCOG, FRANZCOG, CGO, Sydney Gynaecologic Oncology Group, Sydney Cancer Centre, Royal Prince Alfred Hospital, Missenden Road, Camperdown, New South Wales 2050, Australia. Email: chris.dalrymple@email.cs.nws.gov.au

Abstract

Eighty-two patients with adenocarcinoma in situ of the cervix managed at Royal Prince Alfred Hospital were reviewed and data were collected on those treated by cold knife cone biopsy (n= 38) and laser cone biopsy (n= 44). No differences were found in patient age, cytologic or referral history, or outcomes. Having laser excision did not compromise margin status or subsequent management. Invasive disease was found in 24 patients, 16 of whom were managed conservatively with good outcome. Twelve of these were in the laser cone group. In those patients from both groups managed conservatively, there was only one recurrence, squamous preinvasive disease after 8 years. Laser cone biopsy is as effective as cold knife cone biopsy with no compromise of outcome for these patients.

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