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

John Phelps, J. A. Ward, J. Szigeti, C. H. Bowland, A. R. Mayer

Research output: Contribution to journalArticle

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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.

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

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Hysterectomy
Conization
Uterine Cervical Dysplasia
Biopsy
Multicenter Studies
Uterus
Retrospective Studies
Pathology
Neoplasms

ASJC Scopus subject areas

  • Obstetrics and Gynecology

Cite this

Phelps, J., 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.

Cervical cone margins as a predictor for residual dysplasia in post-cone hysterectomy specimens. / Phelps, John; Ward, J. A.; Szigeti, J.; Bowland, C. H.; Mayer, A. R.

In: Obstetrics and Gynecology, Vol. 84, No. 1, 1994, p. 128-130.

Research output: Contribution to journalArticle

Phelps, J, Ward, JA, Szigeti, J, Bowland, CH & Mayer, AR 1994, 'Cervical cone margins as a predictor for residual dysplasia in post-cone hysterectomy specimens', Obstetrics and Gynecology, vol. 84, no. 1, pp. 128-130.
Phelps, John ; Ward, J. A. ; Szigeti, J. ; Bowland, C. H. ; Mayer, A. R. / Cervical cone margins as a predictor for residual dysplasia in post-cone hysterectomy specimens. In: Obstetrics and Gynecology. 1994 ; Vol. 84, No. 1. pp. 128-130.
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N2 - 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.

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