MANAGEMENT OF PATIENTS WITH POSITIVE MARGINS AFTER CERVICAL CONIZATION

Objective: To evaluate conservative management of patients undergoing cervical conization with cone margins positive for dysplasia. Methods: The outcomes of 93 patients with cone biopsies that had margins posit ive for dysplasia were tabulated. Results: Thirty of 47 patients (64%) undergoing conization only and followed by cytology had negative Papa nicolaou smears for at least 2 years. Twenty-one of 37 women (57%) wit h conization and immediate hysterectomy had no residual disease in the cervix. Three of nine women (33%) with conization and delayed hystere ctomy had no detectable dysplasia in the remaining cervix. There was n o case of progression to invasive disease. The overall resolution rate was 58%. Persistence of disease was found most often at the endocervi cal margins associated with cervical intraepithelial neoplasia grade I II. Conclusion: Patients with cone margins positive for dysplasia can be followed appropriately with cytology. In cases of recurrent abnorma l Papanicolaou smears, colposcopy, biopsies, and endocervical curettag e should be repeated.