POSITIVE CONE MARGINS - A DISADVANTAGE OF THE LARGE LOOP EXCISION OF TRANSFORMATION ZONE TECHNIQUE?

The aim was to compare the efficiency of large loop excision of the transformation zone (LLETZ) and cold-knife conization according to the incidence of positive cone margins in histopathologic analysis of the cervical cone. In the study, data obtained from 568 female patients with cone biopsy due to cervical changes during a four-year period (2012-2015) were retrospectively analyzed. Group 1 included patients who were operated on using LLETZ technique and group 2 consisted of patients with cold-knife cone biopsy. LLETZ was a method of choice in 334 (59%) patients, whereas 234 (41%) patients underwent cold-knife cone biopsy. The percentage of positive cone margins was much higher with LLETZ technique, even 39% (131 patients), as compared to 20% with cold-knife cone biopsy. In conclusion, the technique and cone configuration should be individualized, depending on the specifics of the lesion. The transformation zone is not always removed during one LLETZ procedure. High percentage of positive cone margins is not a disadvantage of LLETZ technique because of differences in indications, approach and multiple cutting. The real success of conization can be measured only by the relapse frequency over a long period of time with a high number of patients.