Cervical cone margins as a predictor for residual dysplasia in post-cone hysterectomy specimens.
OBJECTIVE
To determine the relation between dysplasia at cervical cone margins and the presence or absence of residual dysplasia in post-cone hysterectomy specimens.


METHODS
We performed a 6-year retrospective, multicenter study and reviewed 250 cases in which the patient had a cold-knife cervical cone biopsy followed by a hysterectomy within 6 months. Pathology reports from 23 institutions described the margins in conization specimens and the subsequent status of residual dysplasia in the hysterectomy specimens.


RESULTS
There was a statistically significant difference in the prevalence of residual dysplasia in hysterectomy specimens between patients with positive margins on cone biopsy (47%) and those with negative margins (23%) (P < .01). The positive predictive value for residual dysplasia given positive cone margins was 47%, and the negative predictive value was 77%. The grade of post-cone residual dysplasia increased commensurately with the grade of dysplasia in the conization specimen.


CONCLUSIONS
The presence of dysplasia at the cervical cone margin relates significantly with the presence of residual dysplasia in the post-cone hysterectomy specimen. The grade of residual dysplasia in the post-cone hysterectomy specimen increased as the grade of dysplasia in the conization specimen increased. Free margins on a cone biopsy specimen with dysplasia offer reassurance that invasive cancer is not present in the remaining uterus.
Phelps
J Y
JY
Brooke Army Medical Center, San Antonio, Texas.
Ward
J A
JA
Szigeti
J
J
Bowland
C H
CH
Mayer
A R
AR
D000704:Analysis of Variance; D001706:Biopsy / Q000379:methods*; D005260:Female; D006801:Humans; D007044:Hysterectomy; D016014:Linear Models; D011237:Predictive Value of Tests; D015995:Prevalence; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012720:Severity of Illness Index; D002578:Uterine Cervical Dysplasia / Q000453:epidemiology / Q000473:pathology* / Q000601:surgery*