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Predicting risk factors for suboptimal excision in women undergoing cold-knife cone biopsy
L S Massad1, F T Chronopoulos, P M Meyer
1*Division of Gynecologic Oncology, Departments of Obstetrics and Gynecology, Cook County Hospital †Rush Medical College †Section of Biostatistics, Department of Preventive Medicine, Rush Medical College, Chicago, IL.
Objective:
Our goal was to identify risk factors for suboptimal excision in relation to a positive endocervical curettage (ECC) after conization or positive specimen margin.
Materials And Methods:
A retrospective review of referral cy-tology and colposcopy results for 280 women undergoing conization at two urban teaching centers was performed. Mann-Whitney or Pearson's chi-square test was used to de-termine significant associations between preoperative variables and positive cone margin, positive intraoperative ECC, and either positive margin or positive intraoperative ECC.
Results:
Cytology grade, gravidity, parity, and race were not significantly correlated with any outcome variable. Using lo-gistical regression analyses, correlates of positive ECC after conization included increasing age (p = .01), positive colpo-scopic biopsy (p = .01), colposcopic inadequacy (p = .01), and positive preoperative ECC (p = .03). Positive preoperative ECC was the only significant risk factor for positive cone margin (p = .02) or the combination of either positive intraoperative ECC or positive cone margin (p = .0001). Condusion. A positive preoperative ECC is the best predictor of suboptimal excision at conization and should be performed unless contraindi-cated.
