Related Experiment Videos
[Conization with positive margins: what strategy should be adopted?].
F Bretelle1, L Cravello, L Yang
1Service de gynécologie-obstétrique B, hôpital de la Conception, Marseille, France.
Annales De Chirurgie
|August 5, 2000
Summary
Positive margins after cone biopsy do not always mean residual dysplasia. Surveillance with cytology and colposcopy can detect persistent disease, guiding further treatment decisions for cervical intra-epithelial neoplasia (CIN).
Area of Science:
- Gynecologic Oncology
- Cervical Pathology
- Surgical Pathology
Context:
- Positive margins on cone biopsy specimens indicate incomplete removal of cervical intra-epithelial neoplasia (CIN).
- Management strategies for positive margins require careful consideration to balance residual disease risk and overtreatment.
Purpose:
- To define recommended treatment strategies for patients with positive margins following cone biopsy.
- To evaluate the incidence of residual cervical intra-epithelial neoplasia (CIN) after conization with positive margins.
Summary:
- A retrospective study analyzed 70 conizations with positive margins, including cold knife and loop electrosurgical excision procedures.
- Of 55 patients with follow-up, 14.5% had residual CIN 3. Surveillance with cytology and colposcopy detected dysplasia, prompting further intervention in some cases.
- Repeat surgery is recommended for women desiring no further pregnancies, while surveillance is appropriate for others.
Impact:
- This study informs clinical decision-making regarding follow-up and treatment for positive cone biopsy margins.
- Highlights the utility of non-invasive monitoring methods in managing residual dysplasia.
- Contributes to optimizing patient management pathways for cervical precancerous lesions.