Cone biopsy and pathologic findings at radical hysterectomy in stage I cervical carcinoma

OBJECTIVE: To examine the association between cone biopsy and pathologic fi ndings at radical hysterectomy in stage I cervical carcinoma. METHODS: Fifty-four patients diagnosed by cone biopsy with stage I cervical carcinoma and treated with radical hysterectomy comprised the study group. The association between the depth of invasion on conization, lymph-vascula r invasion, positive cone margins, positive endocervical curettage (ECC), a nd the depth of residual invasion in the radical hysterectomy specimen was examined using Pearson r and point biserial correlation. Independent predic tors of the depth of residual invasion were determined by multiple regressi on. RESULTS: The depth of residual invasion correlated significantly-with the d epth of invasion (r=.374) and presence of lymph-vascular invasion (r(pb)=.3 72) in the conization specimen, post-cone ECC status (r(pb) =.669), and age at diagnosis (r=.347). The same factors were jointly assessed using multip le regression (R-2=.636, P<.001). Depth of invasion on conization, lymph-va scular invasion, and ECC status were identified as independent predictors o f the depth of residual invasion. Patients with deep (5 mm or greater) stro mal invasion and lymph-vascular invasion on conization had significantly hi gher rates of positive parametrial margins (22% compared with zero, P=.001) and adjuvant radiation (66.7% compared with 20%, P=.004) compared with all other patients. CONCLUSION: Depth of invasion, presence of lymph-vascular invasion, and age at diagnosis were independent predictors of the depth of residual invasion in the subsequent hysterectomy specimen. These factors should be considere d in treatment planning. Patients with a combination of these factors may h ave increased risk for deep residual invasion, positive hysterectomy margin s, and adjuvant radiation. (Obstet Gynecol 2001;98:779-82. (C) 2001 by the American College of Obstetricians and Gynecologists).