Prevalence and risk factors for residual cervical neoplasia in subsequent hysterectomy following LEEP or conization.
OBJECTIVE
The purposes of the present study were to determine the prevalence of residual disease in the hysterectomy specimens following cold knife conization (CKC) or loop electrosurgical excision procedure (LEEP) and to evaluate the predictive factors for residual disease.


METHODS
Descriptive study


METHODS
Department of Obstetrics and Gynecology, Faculty of Medicine, Siriraj Hospital.


METHODS
A total of 120 patients who underwent hysterectomy after either LEEP or CKC.


METHODS
The medical records of 120 women were reviewed to estimate the prevalence of residual disease.. The patients' characteristic and pathologic parameters were analyzed for the risk factors of residual disease. Chi square test and Student t test were used for statistical analysis.


RESULTS
Of the 120 patients, 46 cases had residual disease in their hysterectomy specimens so the prevalence was 38.3% (95% CI 29.5, 47.2). Invasive cervical cancer was found in the hysterectomy specimens in 4 cases (8.7%). Only ectocervical margin was the predictive factor of residual disease in the hysterectomy specimen (p = 0.002). Age, conization pathologic findings, glandular involvement, endocervical margin status, stromal invasion, and endocervical curettage results were not predictive factors for residual disease in the hystectomy specimens.


CONCLUSIONS
Residual disease was found in 38.3% of hysterectomy specimens after conization. Also undiagnosed invasive cervical cancer was found. Careful examination for residual disease in hysterectomy specimens should be performed, especially among those with positive cone margin.
Natee
Jiraprapa
J
Department of Obstetrics and Gynecology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand.
Therasakvichaya
Suwanit
S
Boriboonhirunsarn
Dittakarn
D
D000328:Adult; D019092:Conization; D003452:Cryosurgery; D004598:Electrosurgery; D005260:Female; D006801:Humans; D007044:Hysterectomy; D008875:Middle Aged; D018365:Neoplasm, Residual / Q000453:epidemiology / Q000209:etiology; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology* / Q000473:pathology* / Q000601:surgery; D002578:Uterine Cervical Dysplasia / Q000453:epidemiology* / Q000473:pathology* / Q000601:surgery