Positive Margin Prevalence and Risk Factors with Cervical Specimens Obtained from Loop Electrosurgical Excision Procedures and Cold Knife Conization

Objectives: To determine the prevalence and predictive factors of residual disease in the specimens fromcold knife conization (CKC) or the loop electrosurgical excision procedure (LEEP) and complication rates ofthese procedures. Design: Descriptive analytical study in Srinangarind Hospital, Khon Kaen, Thailand, of atotal of 463 patients with abnormal Pap smears who underwent LEEP or CKC during 2002-2007.
Methods: Themedical records of 463 women were retrospectively reviewed to ascertain the prevalence, associated factors ofpositive surgical margin, and complications of LEEP and CKC. The patients’ characteristics and pathologicparameters were collected and analyzed. Univariate analysis was based with the chi-square test and the Student’st-test. Multiple logistic regression models were employed to investigate factors associated with cone margininvolvement.
Results: Of the 463 patients, 124 cases had a positive cone margin (26.8%). 53 patients hadcomplications (11.4%), such as bleeding (25) and infection (28). The margin involvement was significantlyassociated with type of conization, purpose of conization, skill of surgeon, and histological diagnosis.
Conclusion:The prevalence of a positive cone margin is rather high. Physicians who perform conization should take intoaccount risk factors in management of cases with abnormal cytological screening for cervical cancer.