Endocervical curettage at conization to predict residual cervical XXXX .

@entity1 @entity15709 @entity420
OBJECTIVE: To determine if performing an endocervical curettage (ECC) at the time of conization is a useful diagnostic tool for predicting residual cervical @entity15709 ( @entity15709 ) among @entity1 who might wish to preserve their fertility. METHODS: All @entity1 diagnosed with @entity15709 from 1995 to 2000 at four institutions were identified. Data were retrospectively extracted from clinical records. @entity1 included in the statistical analysis were (1) younger than 40 years, (2) had an ECC performed at the time of the initial cone biopsy, (3) had a clearly demarcated surgical margin pathologically, and (4) underwent a second surgical procedure. RESULTS: Twenty-nine (24%) of 123 @entity15709 @entity1 met criteria for inclusion. The median age was 33 years (range, 17 to 39) and 13 (46%) were nulliparous. Initial surgery was a cold-knife conization (n = 17) or loop electrosurgical excision procedure (n = 12). Twelve (41%) ECCs and 15 (52%) cone margins were histologically positive. Sixteen @entity1 underwent a repeat conization; 13 underwent hysterectomy. Thirteen (45%) @entity1 had residual @entity15709 at the time of their second surgical procedure. ECC had a superior positive predictive value (100% vs 47%; P < 0.01) and negative predictive value (94% vs 57%; P = 0.01) compared to cone margin in predicting residual @entity15709 . None of the @entity1 undergoing fertility-sparing surgery developed recurrent @entity15709 or @entity420 . CONCLUSION: ECC performed at the time of conization may be a useful tool for predicting residual @entity15709 in @entity1 considering fertility preservation.
