5-YEAR FOLLOW-UP OF PATIENTS WITH CERVICAL INTRAEPITHELIAL NEOPLASIA IN THE CONE MARGINS AFTER CONIZATION

Three hundred eighty-five women treated with conization due to repeate d CIN I, CIN II or CIN III of the cervix uteri have been followed up f or 5 years. All cones were classified according to diagnosis and statu s of the resection margins. A significantly greater recurrence rate of 16.2% was found in the group with neoplasia in the resection margins, in contrast to 3.9% in the group with normal resection margins. Howev er, 83.8% (75.4-92.2%) of patients with neoplasia in the resection mar gins can be expected to be free of recurrence after a 5-year postopera tive follow-up period. Whether the non-free resection margins were end ocervical, ectocervical or both, did not influence the recurrence rate . While the prevalence of non-free resection margins increased signifi cantly with increasing dysplasia, this could not be found with increas ing age. The risk of recurrence could not be correlated with the grade of dysplasia. We conclude that neoplasia in the resection margins of the cone represents an increased risk of recurrence. Therefore, we cha nged the normal smear check-up with a cotton-swab to smear with cyto-b rush, supplemented with colposcopy in the non-free resection margin gr oup, but it remains to be proven that this procedure is safer.