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Predictors of high-grade residual disease after repeat conization in patients with positive surgical margins
, 2, 3, 4, 5, 4, 4
Affiliations- Eskisehir City Hospital, Department of Gynecologic Oncology, Eskisehir, Turkey
- Istanbul University, Institute of Oncology, Department of Medical Oncology, Istanbul, Turkey
- Istanbul Medeniyet University, Goztepe Research and Training Hospital, Department of Gynecology and Obstetrics, Division of Gynecologic Oncology, Istanbul, Turkey
- Istanbul University, Faculty of Medicine, Department of Gynecology and Obstetrics, Division of Gynecologic Oncology, Istanbul, Turkey
- Beykent University, Faculty of Medicine, Department of Biostatistics and Medical Informatics, Istanbul, Turkey
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Abstract
Objectives: No consensus exists on the subsequent management strategy of patients who exhibit positive surgical margin (PSM) after re-excision of high-grade cervical intraepithelial neoplasia (CIN). The aim of the study is to examine the predictors related to the persistence of high-grade CIN lesions after re-excision, where PSM was left behind.
Material and methods: The present retrospective study included patients with PSM who underwent repeated conization due to residual high-grade CIN lesions between January 2005 and December 2019. The SPSS software v20.0 was used for data interpretation and statistical analysis. P values less than 0.05 were accepted as statistically significant.
Results: Repeat conization was performed in 91 patients, 43 (47.3%) presented with PSM with high-grade CIN, 6 (6.5%) presented with micro-invasive carcinoma, and 42 (46.2%) presented with clear surgical margin or CIN 1 at the surgical margin. At the time of conization, patients who presented with lesions > 5 mm in repeat cone specimens, exhibited a significantly higher rate of residual disease (p < 0.001). Besides, the involvement of the endocervical margin with high-grade CIN was the predictor of residual disease in repeat cone specimens (p = 0.006).
Conclusions: In the cone specimen, the presence of lesion size greater than 5 mm and involvement of the endocervical margin were the predictors of high-grade residual disease after re-excision. Whether it is the first or second procedure, great care must be given to excise the lesion entirely at the time of the conization, preferably in one piece.
Abstract
Objectives: No consensus exists on the subsequent management strategy of patients who exhibit positive surgical margin (PSM) after re-excision of high-grade cervical intraepithelial neoplasia (CIN). The aim of the study is to examine the predictors related to the persistence of high-grade CIN lesions after re-excision, where PSM was left behind.
Material and methods: The present retrospective study included patients with PSM who underwent repeated conization due to residual high-grade CIN lesions between January 2005 and December 2019. The SPSS software v20.0 was used for data interpretation and statistical analysis. P values less than 0.05 were accepted as statistically significant.
Results: Repeat conization was performed in 91 patients, 43 (47.3%) presented with PSM with high-grade CIN, 6 (6.5%) presented with micro-invasive carcinoma, and 42 (46.2%) presented with clear surgical margin or CIN 1 at the surgical margin. At the time of conization, patients who presented with lesions > 5 mm in repeat cone specimens, exhibited a significantly higher rate of residual disease (p < 0.001). Besides, the involvement of the endocervical margin with high-grade CIN was the predictor of residual disease in repeat cone specimens (p = 0.006).
Conclusions: In the cone specimen, the presence of lesion size greater than 5 mm and involvement of the endocervical margin were the predictors of high-grade residual disease after re-excision. Whether it is the first or second procedure, great care must be given to excise the lesion entirely at the time of the conization, preferably in one piece.
Keywords
cancer of the cervix; cytology and GYN pathology; HPV infection and CIN
About this articleTitle
Predictors of high-grade residual disease after repeat conization in patients with positive surgical margins
Journal
Issue
Article type
Research paper
Pages
962-967
Published online
2022-05-23
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3479
Article views/downloads
553
DOI
Pubmed
Bibliographic record
Ginekol Pol 2022;93(12):962-967.
Keywords
cancer of the cervix
cytology and GYN pathology
HPV infection and CIN
Authors
Yagmur Minareci
Naziye Ak
Ozgur Aydin Tosun
Hamdullah Sozen
Rian Disci
Samet Topuz
Mehmet Yavuz Salihoglu
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