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Int J Gynaecol Obstet. 2013 Apr;121(1):49-52. doi: 10.1016/j.ijgo.2012.10.029. Epub 2013 Jan 17.

Post-conization endocervical curettage for estimating the risk of persistent or recurrent high-grade dysplasia.

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1
Department of Pathology, Soroka Medical Center, Be'er Sheva, Israel. rsl@bgu.ac.il

Abstract

OBJECTIVE:

To evaluate the association between post-cone endocervical curettage (ECC) results, either alone or with cone margin status, and persistent/recurrent high-grade dysplasia after conization.

METHODS:

The medical records of 250 women who underwent a loop electrosurgical excision procedure with post-cone ECC at Soroka Medical Center, Be'er Sheva, Israel, between January 2001 and July 2011 were reviewed retrospectively.

RESULTS:

Thirty-one women (12.4%) had evidence of high-grade dysplasia in the ECC sample. Factors associated with positive ECC were being older than 35 years (P=0.004) and positive margin status (P=0.001). Twenty-nine patients (11.6%) had persistent/recurrent high-grade dysplasia. Both high-grade dysplasia in the ECC sample (hazard ratio, 2.31; P=0.032) and positive cone margins (hazard ratio, 23.4; P<0.001) were associated with persistent/recurrent disease.

CONCLUSION:

High-grade dysplasia in the ECC sample was associated with positive cone margin status. These 2 factors were both associated with persistent/recurrent disease. Among patients with positive cone margins, a combination of margin status and ECC was superior to margin status alone for estimating the probability of persistent/recurrent disease. For women with negative cone margins, ECC was less useful. Because ECC is valuable for assessing the risk of persistent/recurrent high-grade dysplasia in many cases, post-cone ECC should be performed routinely with conization.

PMID:
23332656
DOI:
10.1016/j.ijgo.2012.10.029
[Indexed for MEDLINE]
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