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The appropriate cone depth to avoid endocervical margin involvement is dependent on age and disease severity.
MedLine Citation:
PMID:  23034067     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Objective. To analyze factors associated with endocervical cone margin involvement and suggest appropriate cone depth in the conization procedure. Design. Retrospective cohort study. Setting. Gynecological oncology center. Population. 1 220 women undergoing conization for cervical intraepithelial neoplasia (CIN) II, III or stage IA1 microinvasive cervical carcinoma. Methods. The following factors were analyzed: age, parity, gravida, conization type, margin status, disease severity and specimen depth. Receiver operating characteristic (ROC) curve analyses were used to determine the best cut-off points to define appropriate cone depth. Main outcome measure. Cone depth to avoid endecervical margin involvement. Results. 91 women had endocervical margin involvement (7.5%). This was positively associated with disease severity and age and inversely related to cone depth. In women under 50 years, the cut-off value was achieved at 1.8 cm cone depth with high sensitivity and relatively low specificity (AUC 0.64, sensitivity 0.86, specificity 0.27, p = 0.005). For a subset of CIN II patients aged ≤50 years, the cut-off value was 1.2 cm (AUC 0.75, sensitivity 0.90, specificity 0.47, p = 0.008). In women <40 years of age, the cut-off value was 1.8 cm (AUC 0.60, sensitivity 0.88, specificity 0.25, p = 0.036). In a subset of CIN II, the cut-off value was 0.9 cm (AUC 0.87, sensitivity 0.83, specificity 0.69, p = 0.002). Conclusions. Age, disease severity, and cone depth are predictive factors for endocervical margin involvement. In women of reproductive age, the appropriate cone depth to avoid endocervical margin involvement can be changed depending on age and disease severity condition.
Authors:
Hyo Sook Bae; Ye Won Chung; Tak Kim; Kyu Wan Lee; Jae Yun Song
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-10-4
Journal Detail:
Title:  Acta obstetricia et gynecologica Scandinavica     Volume:  -     ISSN:  1600-0412     ISO Abbreviation:  Acta Obstet Gynecol Scand     Publication Date:  2012 Oct 
Date Detail:
Created Date:  2012-10-4     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370343     Medline TA:  Acta Obstet Gynecol Scand     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2012 The Authors Acta Obstetricia et Gynecologica Scandinavica© 2012 Nordic Federation of Societies of Obstetrics and Gynecology.
Affiliation:
Department of Obstetrics and Gynecology, Korea University College of Medicine, Seoul, Korea.
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