Correlating cone biopsy histology with operative indications

Gynecologic Oncology
L S MassadH E Cejtin

Abstract

To correlate operative indications for and histologic findings of cold knife cone biopsy since introduction of the Bethesda system for classification of cervical cytology. Patients undergoing cold knife conization of the cervix at adjacent urban medical centers were identified from operating logs. Data on indication and outcome were tabulated retrospectively for 294 women. Cone biopsy indications were sometimes multiple and included dysplastic or malignant endocervical curettage (ECC) in 66%, inadequate colposcopy in 48%, cytologic:histologic discrepancy in 16%, and suspicion of invasive cancer on biopsy in 1% of cone biopsies. For 8% of patients, none of these indications were found. The respective proportions of women with benign findings or atypical, low-grade dysplasia, high-grade dysplasia, or cancer was 16, 15, 65, and 3% for positive ECC, 26, 16, 54, and 4% for inadequate colposcopy, 22, 17, 59, and 0% for discrepancy, and 0, 0, 100, and 0% for suspicion of cancer on cytology. Outcomes were significantly worse among women with positive ECC (OR = 2.1, P = 0.006). The likelihood of identifying high-grade lesions in cone biopsy specimens is high, especially among women with a positive ECC, but the risk of cancer is low.

References

Jul 1, 1989·American Journal of Obstetrics and Gynecology·M S BaggishM Adelson
Nov 1, 1994·Gynecologic Oncology·R W NaumannJ B Hall

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Citations

Jun 15, 1999·Gynecologic Oncology·M AzodiJ T Chambers
May 5, 2005·Journal of Lower Genital Tract Disease·L Stewart MassadYvonne C Collins
Jun 5, 2013·Journal of Lower Genital Tract Disease·Emily FukuchiRamey D Littell

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