CONSERVATIVE MANAGEMENT OF OPTIONS FOR PATIENTS WITH DYSPLASIA INVOLVING ENDOCERVICAL MARGINS OF CERVICAL CONE BIOPSY SPECIMENS

OBJECTIVE: Our purpose was to study the feasibility of conservatively managing selected cases of dysplasia involving endocervical cone margi ns. STUDY DESIGN: A retrospective review of patients conservatively ma naged after being found to have squamous cell dysplasia involving the endocervical margins of their cervical cone biopsy specimens. In phase I patients who had cold-knife conization with positive endocervical m argins underwent repeat Papanicolaou smears and colposcopy, with biops ies and endocervical curettage as indicated. Those found free of disea se were followed up with frequent Papanicolaou smears. In phase II pat ients with dysplasia to the endocervical resection edges on loop elect rical excision procedure biopsy specimens were followed up with freque nt cytologic studies. RESULTS: In phase 1, 31 patients with positive e ndocervical margins on cold-knife conization and no evidence of dyspla sia on reevaluation were followed up for 1 to 18 years. Dysplasia was detected in one patient during cytologic surveillance. In phase II, 11 patients were followed up for 12 to 31 months; only one patient has d ysplasia. CONCLUSION: Selected patients with squamous cell dysplasia a t endocervical cone biopsy margins may avoid additional surgery.