Cervical cone margins as a predictor for residual dysplasia in post-cone hysterectomy specimens

John Y. Phelps, John A. Ward, Julius Szigeti, Carla Hawley Bowland, Allan R. Mayer

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42 Scopus citations

Abstract

Objective: To determine the relation between dysplasia at cervical cone margins and the presence or absence of residual dysplasia in post-cone hysterectomy specimens. Methods: We performed a 6-year retrospective, multicenter study and reviewed 250 cases in which the patient had a cold-knife cervical cone biopsy followed by a hysterectomy within 6 months. Pathology reports from 23 institutions described the margins in conization specimens and the subsequent status of residual dysplasia in the hysterectomy specimens. Results: There was a statistically significant difference in the prevalence of residual dysplasia in hysterectomy specimens between patients with positive margins on cone biopsy (47%) and those with negative margins (23%) (P < .01). The positive predictive value for residual dysplasia given positive cone margins was 47%, and the negative predictive value was 77%. The grade of post-cone residual dysplasia increased commensurately with the grade of dysplasia in the conization specimen. Conclusions: The presence of dysplasia at the cervical cone margin relates significantly with the presence of residual dysplasia in the post-cone hysterectomy specimen. The grade of residual dysplasia in the post-cone hysterectomy specimen increased as the grade of dysplasia in the conization specimen increased. Free margins on a cone biopsy specimen with dysplasia offer reassurance that invasive cancer is not present in the remaining uterus. (Obstet Gynecol 1994;84:128-30).

Original languageEnglish (US)
Pages (from-to)128-130
Number of pages3
JournalObstetrics and gynecology
Volume84
Issue number1
StatePublished - Jul 1994

ASJC Scopus subject areas

  • Obstetrics and Gynecology

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    Phelps, J. Y., Ward, J. A., Szigeti, J., Bowland, C. H., & Mayer, A. R. (1994). Cervical cone margins as a predictor for residual dysplasia in post-cone hysterectomy specimens. Obstetrics and gynecology, 84(1), 128-130.