[The optimal treatment of carcinoma in situ of the uterine cervix (author's transl)].

The results of treatment of carcinoma in situ of the uterine cervix in 380 patients seen between January 1, 1966 and December 31, 1973 are reported. There were 134 women age 40 or less. There were 246 patients age 40 or older. In 334 patients a total hysterectomy with removal of a vaginal cuff was carried out (87.9%). A large therapeutic cone biopsy was done in 46 patients (12.1%). In the 334 patients treated by hysterectomy, 2 recurrent carcinomas in situ of the vaginal vault were observed (0.6%). In 16 of the cases treated by conization later suspicious colposcopic and/or cytologic findings made hysterectomy necessary. In 5 of these cases a recurrent carcinoma in situ was likely. The postoperative morbidity after total hysterectomy was low. There was no postoperative death. The total vaginal hysterectomy with removal of a vaginal cuff is recommended as treatment for carcinoma in situ of the uterine cervix in order to avoid the diagnostic difficulties in the follow-up after treatment by conization and because of the low recurrence rate after hysterectomy. Conservative treatment should only be employed in patients who desire later child bearing. tthe psychological stresses of the continually required follow-up examinations after conization should not be underestimated.