title: Post-conization endocervical curettage for estimating the risk of persistent or recurrent high-grade dysplasia.
abstract: OBJECTIVE
  To evaluate the association between post-cone endocervical curettage (ECC) results, either alone or with cone margin status, and persistent/recurrent high-grade dysplasia after conization.
  
  
  METHODS
  The medical records of 250 women who underwent a loop electrosurgical excision procedure with post-cone ECC at Soroka Medical Center, Be'er Sheva, Israel, between January 2001 and July 2011 were reviewed retrospectively.
  
  
  RESULTS
  Thirty-one women (12.4%) had evidence of high-grade dysplasia in the ECC sample. Factors associated with positive ECC were being older than 35 years (P=0.004) and positive margin status (P=0.001). Twenty-nine patients (11.6%) had persistent/recurrent high-grade dysplasia. Both high-grade dysplasia in the ECC sample (hazard ratio, 2.31; P=0.032) and positive cone margins (hazard ratio, 23.4; P<0.001) were associated with persistent/recurrent disease.
  
  
  CONCLUSIONS
  High-grade dysplasia in the ECC sample was associated with positive cone margin status. These 2 factors were both associated with persistent/recurrent disease. Among patients with positive cone margins, a combination of margin status and ECC was superior to margin status alone for estimating the probability of persistent/recurrent disease. For women with negative cone margins, ECC was less useful. Because ECC is valuable for assessing the risk of persistent/recurrent high-grade dysplasia in many cases, post-cone ECC should be performed routinely with conization.
authors: Department of Pathology, Soroka Medical Center, Be'er Sheva, Israel. rsl@bgu.ac.il
authors: Ruthy
authors: R
authors: Shaco-Levy
authors: Mihai
authors: M
authors: Meirovitz
authors: Gilad
authors: G
authors: Eger
authors: Daniel
authors: D
authors: Benharroch
authors: Jacob
authors: J
authors: Dreiher
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D019092:Conization / Q000379:methods*; D003475:Curettage / Q000379:methods*; D004598:Electrosurgery; D005260:Female; D006801:Humans; D007557:Israel; D008875:Middle Aged; D016016:Proportional Hazards Models; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D002578:Uterine Cervical Dysplasia / Q000453:epidemiology / Q000473:pathology* / Q000601:surgery; D055815:Young Adult