Premium
Post‐conization endocervical curettage for estimating the risk of persistent or recurrent high‐grade dysplasia
Author(s) -
ShacoLevy Ruthy,
Meirovitz Mihai,
Eger Gilad,
Benharroch Daniel,
Dreiher Jacob
Publication year - 2013
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1016/j.ijgo.2012.10.029
Subject(s) - medicine , endocervical curettage , dysplasia , hazard ratio , surgery , colposcopy , confidence interval , cancer , cervical cancer
Objective To evaluate the association between post‐cone endocervical curettage (ECC) results, either alone or with cone margin status, and persistent/recurrent high‐grade dysplasia after conization. Methods The medical records of 250 women who underwent a loop electrosurgical excision procedure with post‐cone ECC at Soroka Medical Center, Be'er Sheva, Israel, between January 2001 and July 2011 were reviewed retrospectively. Results Thirty‐one women (12.4%) had evidence of high‐grade dysplasia in the ECC sample. Factors associated with positive ECC were being older than 35 years ( P = 0.004) and positive margin status ( P = 0.001). Twenty‐nine patients (11.6%) had persistent/recurrent high‐grade dysplasia. Both high‐grade dysplasia in the ECC sample (hazard ratio, 2.31; P = 0.032) and positive cone margins (hazard ratio, 23.4; P < 0.001) were associated with persistent/recurrent disease. Conclusion High‐grade dysplasia in the ECC sample was associated with positive cone margin status. These 2 factors were both associated with persistent/recurrent disease. Among patients with positive cone margins, a combination of margin status and ECC was superior to margin status alone for estimating the probability of persistent/recurrent disease. For women with negative cone margins, ECC was less useful. Because ECC is valuable for assessing the risk of persistent/recurrent high‐grade dysplasia in many cases, post‐cone ECC should be performed routinely with conization.