Predictors of high-grade residual disease after repeat conization in patients with positive surgical margins.

Autor:	Minareci Y; Eskisehir City Hospital, Department of Gynecologic Oncology, Eskisehir, Turkey. dryagmurminareci@gmail.com., Ak N; Istanbul University, Institute of Oncology, Department of Medical Oncology, Istanbul, Turkey., Tosun OA; Istanbul Medeniyet University, Goztepe Research and Training Hospital, Department of Gynecology and Obstetrics, Division of Gynecologic Oncology, Istanbul, Turkey., Sozen H; Istanbul University, Faculty of Medicine, Department of Gynecology and Obstetrics, Division of Gynecologic Oncology, Istanbul, Turkey., Disci R; Beykent University, Faculty of Medicine, Department of Biostatistics and Medical Informatics, Istanbul, Turkey., Topuz S; Istanbul University, Faculty of Medicine, Department of Gynecology and Obstetrics, Division of Gynecologic Oncology, Istanbul, Turkey., Salihoglu MY; Istanbul University, Faculty of Medicine, Department of Gynecology and Obstetrics, Division of Gynecologic Oncology, Istanbul, Turkey.
Jazyk:	angličtina
Zdroj:	Ginekologia polska [Ginekol Pol] 2022; Vol. 93 (12), pp. 962-967. Date of Electronic Publication: 2022 Jul 27.
DOI:	10.5603/GP.a2022.0019
Abstrakt:	Objectives: No consensus exists on the subsequent management strategy of patients who exhibit positive surgical margin (PSM) after re-excision of high-grade cervical intraepithelial neoplasia (CIN). The aim of the study is to examine the predictors related to the persistence of high-grade CIN lesions after re-excision, where PSM was left behind. Material and Methods: The present retrospective study included patients with PSM who underwent repeated conization due to residual high-grade CIN lesions between January 2005 and December 2019. The SPSS software v20.0 was used for data interpretation and statistical analysis. P values less than 0.05 were accepted as statistically significant. Results: Repeat conization was performed in 91 patients, 43 (47.3%) presented with PSM with high-grade CIN, 6 (6.5%) presented with micro-invasive carcinoma, and 42 (46.2%) presented with clear surgical margin or CIN 1 at the surgical margin. At the time of conization, patients who presented with lesions > 5 mm in repeat cone specimens, exhibited a significantly higher rate of residual disease (p < 0.001). Besides, the involvement of the endocervical margin with high-grade CIN was the predictor of residual disease in repeat cone specimens (p = 0.006). Conclusions: In the cone specimen, the presence of lesion size greater than 5 mm and involvement of the endocervical margin were the predictors of high-grade residual disease after re-excision. Whether it is the first or second procedure, great care must be given to excise the lesion entirely at the time of the conization, preferably in one piece.
Databáze:	MEDLINE
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