AIS

Question 1

Average interval between diagnosis of clinically detectable AIS and early invasive cancer?

Answer 1

at least 5 years

Question 2

% of AIS having coexistent squamous lesion?

Answer 2

55%

Question 3

How HPV-18 positivity in 38-50% of AIS (only in 8% of >CIN2) and in 50% of cvx ca (adeno+sq) translates to management?

Answer 3

For HPV-18 w/ normal colpo, ECC is acceptable per SGO

Question 4

AIS with positive margin at cone: next step? AIS_SGO 2020

Answer 4

2nd excisional procedure before hysterectomy unless can’t be done safely

Question 5

🔄 of AIS ~ margins status?

Answer 5

3% w/ negative margins

19% w/ ➕

Question 6

AIS ≠ margins: risk of residual pathology on 2nd excisional specimen?

Answer 6

20% for AIS - 2% ca, if margin negative

53% - 6% if initial margin ➕

Question 7

Type of hysterectomy for AIS with persistently ➕ margins?

Answer 7

MRH or radical trachelectomy as well as simple hysterectomies are acceptable

GOG-278: Hyst+LND for s. IA1-IB1 cvx ca - pending as off 2020

Question 8

Incidence of ➕ LN in AIS patients postoperatively diagnosed with microinvasive adenocarcinoma?

Answer 8

1-3%

Therefore LN assessment is not required at the time of surgery, but acceptable

AIS_SGO 2020

Question 9

Risk of ovarian metz with cervical adenocarcinoma?

Answer 9

2-5% vs. <1% for squamous

~stage
~depth of stromal invasion

• thus very rare for AIS

Question 10

Completion of tx for AIS after completion of childbearing?

Answer 10

HPV+: Hyst preferred

Consistently neg HPV: Hyst vs. surveillance are acceptable

CIII

Question 11

Surveillance for AIS:

Answer 11

For at least 25 years

Fertility sparing: Pap+HPV+Endocervical sampling q6m x 3y; than yearly x 2

If 🔄HPV is negative over 5y: acceptable to 🔼 to q3y indefinitely