An Analysis of Residual Disease in Hysterectomy Specimens After Cone Biopsy

Abstract

The records of 167 patients who underwent both cone biopsy and hysterectomy at the University of Michigan Medical Center between 1974 and 1989 were reviewed. The presence or absence of neoplasia at the cone biopsy margins was able to be correlated with the extent of residual disease in the hysterectomy specimens for 138 patients. When all patients were evaluated, residual disease was found in 64 of 82 cases (78%) when the cone biopsy margins were involved and in 14 of 56 cases (25%) when the cone margins were free. Among patients with preinvasive disease on cone biopsy, 37 of 50 (74%) had residual disease when the cone margins were involved and 11 of 48 (23%) had residual disease when the cone margins were free. No patient with mild to moderate dysplasia on cone biopsy had residual disease more advanced than moderate dysplasia, regardless of margin status. When the margins were free on cone biopsy, there was no residual disease in 12 of 15 patients (80%) with severe dysplasia and no residual disease in 18 of 22 patients (82%) with CIS. These findings suggest that patients with mild to moderate dysplasia regardless of cone margins, severe dysplasia, and CIS with free cone margins have a low rate of residual disease remaining in the cervix. (J GYNECOL SURG 9:17, 1993)