Korean J Obstet Gynecol.  2011 Dec;54(12):764-769. 10.5468/KJOG.2011.54.12.764.

The analysis of factors which affect resection margin status after conization for cervical intraepithelial neoplasia

• Jung CN
• Oh NJ
• Ryu KY
• Oh HE
• Kim WY

• KMID: 1443940
• DOI: http://doi.org/10.5468/KJOG.2011.54.12.764

Abstract

OBJECTIVE
The aim of this study was to evaluate the correlation between resection margin status after conization and severity of dysplasia and to evaluate the risk of residual disease and recurrence for positive resection margin after conization.
METHODS
We retrospectively reviewed the medical and histopathological records of 202 patients who underwent conization that revealed cervical intraepithelial neoplasia (CIN) at Myongji Hospital, Kwandong University College of Medicine between November 2003 and February 2011. Patients were followed up every three to six months with cervicovaginal smears, and suspected cases of recurrence were subjected to colposcopy and biopsy.
RESULTS
A total of 202 patients underwent conization (46 [22.8%] with CIN I, 35 [17.3%] with CIN II, 121 [59.9%] with CIN III) and were enrolled this study. The cone resection margin involved in 33.2% (67/202) of the patients (7/67 [10.4%] with CIN I, 14/67 [20.9%] with CIN II, 46/67 [68.7%] with CIN III). The frequency of resection margin involvement after conization was higher with increasing severity of CIN (P = 0.009). Hysterectomy was performed in 28 patients (13.9%). The incidence of residual disease was 53.8% (7/13) in resection margin free group and 33.3% (5/15) in resection margin involvement group (P = 0.445). There were three (3/52, 5.7%) recurrence in resection margin involvement group and two (2/122, 1.6%) recurrence in resection margin free group (P = 0.335).
CONCLUSION
The risk of resection margin involvement after conization increased with increasing severity of CIN. However, the women with involvement of resection margin after conization often have no residual disease and there was no difference in recurrence between the resection margin status. Therefore, patients whose resection margins were involved after conization could be managed conservatively.

Keyword

Cervical intraepithelial neoplasia; Conization; Resection margin; Residual disease; Recurrence

MeSH Terms

Cervical Intraepithelial Neoplasia
Colposcopy
Conization
Female
Humans
Hysterectomy
Incidence
Recurrence
Retrospective Studies

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