Positive margin prevalence and risk factors with cervical specimens obtained from loop electrosurgical excision procedures and cold knife conization.
OBJECTIVE
To determine the prevalence and predictive factors of residual disease in the specimens from cold knife conization (CKC) or the loop electrosurgical excision procedure (LEEP) and complication rates of these procedures.


METHODS
Descriptive analytical study in Srinangarind Hospital, Khon Kaen, Thailand, of a total of 463 patients with abnormal Pap smears who underwent LEEP or CKC during 2002-2007.


METHODS
The medical records of 463 women were retrospectively reviewed to ascertain the prevalence, associated factors of positive surgical margin, and complications of LEEP and CKC. The patients' characteristics and pathologic parameters were collected and analyzed. Univariate analysis was based with the chi-square test and the Student's t-test. Multiple logistic regression models were employed to investigate factors associated with cone margin involvement.


RESULTS
Of the 463 patients, 124 cases had a positive cone margin (26.8%). 53 patients had complications (11.4%), such as bleeding (25) and infection (28). The margin involvement was significantly associated with type of conization, purpose of conization, skill of surgeon, and histological diagnosis.


CONCLUSIONS
The prevalence of a positive cone margin is rather high. Physicians who perform conization should take into account risk factors in management of cases with abnormal cytological screening for cervical cancer.
Panna
Sunida
S
Department of Obstetrics and Gynecology, Faculty of Medicine, Srinangarind Hospital, Khon Kaen University, Khon Kaen, Thailand.
Luanratanakorn
Sanguanchoke
S
D000230:Adenocarcinoma / Q000473:pathology / Q000601:surgery; D000328:Adult; D002294:Carcinoma, Squamous Cell / Q000556:secondary / Q000601:surgery; D019092:Conization; D004598:Electrosurgery; D005260:Female; D006801:Humans; D015994:Incidence; D018365:Neoplasm, Residual / Q000453:epidemiology* / Q000209:etiology; D015995:Prevalence; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate; D013785:Thailand / Q000453:epidemiology; D002583:Uterine Cervical Neoplasms / Q000473:pathology* / Q000601:surgery*; D002578:Uterine Cervical Dysplasia / Q000473:pathology* / Q000601:surgery*