Objective: We aimed to identify if there is any predictor of residual disease at repeat operation after cervical conization with positive surgical margins for high-grade squamous intraepithelial lesion (HSIL) or microinvasive cervical cancer.
Materials and methods: Records of patients who underwent immediate repeat conization or hysterectomy because of positive surgical margins for HSIL or microinvasive cervical cancer reported after conization were obtained. The relation between the residual disease and age, parity, menopausal status, and the factors of first conization (method, cone base area, height of cone, endocervical margin, glandular and endocervical curettage specimen involvement, and the number of quadrants with positive surgical margins) was assessed. Standard statistical tests were used.
Results: Seventy-four patients were included. Mean time between the 2 operations was 5.1 weeks. Thirty-four patients (45.9%) had residual disease in the second-operation specimen: 4 low-grade squamous intraepithelial lesions, 24 HSILs, 5 microinvasive lesion, and 1 invasive cervical carcinoma. The number of involved quadrants was the only predictor of residual disease (41% if ≤2 and 80% if >2, p = .02).
Conclusions: Residual disease is found in nearly half of repeat operations after conization with positive margins for HSIL or microinvasive cervical cancer. Particularly, residual disease is present in 80% of the patients with more than 2 involved quadrants. This should be considered when making management decisions.