Cervical adenocarcinoma in situ
ICD-10 D06 ICD-11 2E66

Management of Cervical Adenocarcinoma In Situ in Reproductive-Age Patients Who Desire Future Pregnancy

Clinical Scenario

This protocol addresses patients of reproductive age diagnosed with cervical adenocarcinoma in situ who wish to preserve fertility. The relevant conditions for this pathway are: negative margin status has been achieved on cervical conization, and the patient is willing and able to adhere to ongoing surveillance recommendations.

Why This Scenario Matters

The combination of reproductive-age presentation, fertility intent, confirmed negative conization margins, and commitment to surveillance defines a specific subgroup for whom conservative — rather than definitive surgical — management may be appropriate. Each of these criteria shapes the clinical decision pathway.

Approach Overview (Partial)

The recommended approach involves fertility-sparing management centred on conization with negative margins, followed by close surveillance. The full structured regimen — including surveillance intervals, criteria for escalation, and the complete evidence-graded recommendations — is detailed in the protocol.

Instant Access to Structured Evidence-Based Regimens

References

For patients of reproductive age who desire future pregnancy, for whom negative margin status on conization has been achieved, and who are willing and able to adhere to surveillance recommendations, fertility-sparing management with a conization procedure is acceptable (AII).

DOI: 10.1097/AOG.0000000000003761

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