Clinicopathologic Variables Related to Residual Neoplasia after Cervical Conization / 대한산부인과학회잡지

ABSTRACT

OBJECTIVE: To evaluate the clinicopathologic variables that are important for predicting residual disease after cervical conization in hysterectomy specimens. METHODS: We performed retrospective review of 125 patients who had undergone cervical conization and endocervical curettage followed by subsequent hysterectomy. Pathologic findings of the cone margins, endocervical curettage samples, and residual lesions in the postcone hysterectomy specimens were recorded for analysis. RESULTS: The prevalence rates of positive cone margins increased with higher severity of cervical neoplasia. There was a statistically significant difference in the prevalence of residual disease in hysterectomy specimens between patients with positive endocervical margins on cone biopsy(67.3%) and those with negative margins(11.8%) (p<0.01). Most residual lesions in the postcone hysterectomy specimens were similar to cone pathology, however the possibility of more advanced lesions in the uterus was present in patients with positive cone margins. Residual disease was significantly more frequently found in patients with positive endocervical curettage(82.4%)(p<0.01). Especially, when both the endocervical margin and endocervical curettage were positive, residual disease was present in 25 of 28 (89.3%) hysterectomy specimens. CONCLUSIONS: From these results, we concluded that the status of endocervical margin and endocervical curettage have significant predictive value with respect to the presence or absence of residual disease, and final decision in regard to subsequent management should be based on histologic finding of the cone margins and endocervical curettage as well as the patient's age and desire to retain reproductive capability.