title: The significance of cone biopsy resection margins.
abstract: This 12-year retrospective study examines the significance of margin involvement with dysplasia at cone biopsy in relation to follow-up. Of 300 cone biopsies, 123 (41%) had margin involvement. These cases of margin involvement were associated with more severe dysplasia (P less than 0.0001) and a higher chance of subsequent abnormal cytological follow-up (P less than 0.0001) and residual dysplasia at subsequent surgery (P less than 0.0001). Involvement of the endocervical margin at the initial cone biopsy was a sensitive predictor of future abnormality, with an incidence of subsequent abnormal cytology of 29% and residual disease of 82% in those undergoing further surgery. In those cases where the margins had been clear, the incidence of abnormal cytological follow-up was 8%, with 12% residual disease in those undergoing subsequent surgery. Margin involvement was a better predictor of residual disease at repeat surgery than abnormal follow-up cytology (positive predictive value, 79% vs 60%, respectively).
authors.affiliation: St. Thomas' Hospital, London, United Kingdom.
authors.forename: S
authors.initials: S
authors.lastname: Paterson-Brown
authors.forename: O A
authors.initials: OA
authors.lastname: Chappatte
authors.forename: S K
authors.initials: SK
authors.lastname: Clark
authors.forename: A
authors.initials: A
authors.lastname: Wright
authors.forename: P
authors.initials: P
authors.lastname: Maxwell
authors.forename: N A
authors.initials: NA
authors.lastname: Taub
authors.forename: K S
authors.initials: KS
authors.lastname: Raju
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001706:Biopsy / Q000379:methods*; D002278:Carcinoma in Situ / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D008875:Middle Aged; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D002583:Uterine Cervical Neoplasms / Q000473:pathology* / Q000601:surgery