Prediction of clearance of cervical intraepithelial neoplasia by conization

In this review of 531 cervical conizations and 268 hysterectomies, the presence or absence of cervical intraepithelial neoplasia (CIN) at the margins of the cervical conization failed to predict the presence or absence of residual neoplasia in the excised uterus (P greater than .10). Older patients and patients with CIN III Papanicolaou smears had a significantly greater chance of having noncleared cone margins (P less .0005); no other criteria predictive of non-clearance emerged in this study. Two of 26 patients with CIN III at the cone apex or in the apical biopsies had residual stage IA neoplasia in the excised uterus. Conversely, when the cone predicted clearance, CIN III was the worst residual diagnosis.