CERVICAL CONE MARGINS AS A PREDICTOR FOR RESIDUAL DYSPLASIA IN POST-CONE HYSTERECTOMY SPECIMENS

Objective: To determine the relation between dysplasia at cervical con e margins and the presence or absence of residual dysplasia in post-co ne hysterectomy specimens. Methods: We performed a 6-year retrospectiv e, multicenter study and reviewed 250 cases in which the patient had a cold-knife cervical cone biopsy followed by a hysterectomy within 6 m onths. 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 sign ificant difference in the prevalence of residual dysplasia in hysterec tomy specimens between patients with positive margins on cone biopsy ( 47%) and those with negative margins (23%) (P < .01), The positive pre dictive value for residual dysplasia given positive cone margins was 4 7%, and the negative predictive value was 77%. The grade of post-cone residual dysplasia increased commensurately with the grade of dysplasi a in the conization specimen. Conclusions: The presence of dysplasia a t the cervical cone margin relates significantly with the presence of residual dysplasia in the post-tone hysterectomy specimen. The grade o f residual dysplasia in the post-tone hysterectomy specimen increased as the grade of dysplasia in the conization specimen increased. Free m argins on a cone biopsy specimen with dysplasia offer reassurance that invasive cancer is not present in the remaining uterus.