title: Is there any predictor for residual disease after cervical conization with positive surgical margins for HSIL or microinvasive cervical cancer?
abstract: OBJECTIVE
  We aimed to identify if there is any predictor of residual disease at repeat operation after cervical conization with positive surgical margins for high-grade squamous intraepithelial lesion (HSIL) or microinvasive cervical cancer.
  
  
  METHODS
  Records of patients who underwent immediate repeat conization or hysterectomy because of positive surgical margins for HSIL or microinvasive cervical cancer reported after conization were obtained. The relation between the residual disease and age, parity, menopausal status, and the factors of first conization (method, cone base area, height of cone, endocervical margin, glandular and endocervical curettage specimen involvement, and the number of quadrants with positive surgical margins) was assessed. Standard statistical tests were used.
  
  
  RESULTS
  Seventy-four patients were included. Mean time between the 2 operations was 5.1 weeks. Thirty-four patients (45.9%) had residual disease in the second-operation specimen: 4 low-grade squamous intraepithelial lesions, 24 HSILs, 5 microinvasive lesion, and 1 invasive cervical carcinoma. The number of involved quadrants was the only predictor of residual disease (41% if ≤2 and 80% if >2, p = .02).
  
  
  CONCLUSIONS
  Residual disease is found in nearly half of repeat operations after conization with positive margins for HSIL or microinvasive cervical cancer. Particularly, residual disease is present in 80% of the patients with more than 2 involved quadrants. This should be considered when making management decisions.
authors.affiliation: Gynecologic Oncology Department, Etlik Zubeyde Hanim Women's Health Teaching and Research Hospital, Ankara, Turkey.
authors.forename: Tolga
authors.initials: T
authors.lastname: Tasci
authors.forename: Taner
authors.initials: T
authors.lastname: Turan
authors.forename: Isin
authors.initials: I
authors.lastname: Ureyen
authors.forename: Alper
authors.initials: A
authors.lastname: Karalok
authors.forename: Rukiye
authors.initials: R
authors.lastname: Kalyoncu
authors.forename: Nurettin
authors.initials: N
authors.lastname: Boran
authors.forename: Gokhan
authors.initials: G
authors.lastname: Tulunay
mesh_terms: D000328:Adult; D000368:Aged; D019092:Conization / Q000379:methods*; D005260:Female; D006801:Humans; D008875:Middle Aged; D018365:Neoplasm, Residual / Q000175:diagnosis*; D012189:Retrospective Studies; D065310:Squamous Intraepithelial Lesions of the Cervix / Q000601:surgery*; D016896:Treatment Outcome; D002583:Uterine Cervical Neoplasms / Q000601:surgery*