Factors That Influence Surgical Margin State in Patients Undergoing Cold Knife Conization - A Single Center Experience.
AIM
To evaluate the factors that influence the surgical margin state in patients undergoing cold knife conization at the University Clinic of Gynecology and Obstetrics in Skopje, Republic of Macedonia Materials and methods: We have retrospectively analyzed the medical records of all patients that underwent a cold knife conization at our Clinic in 2015. We cross-referenced the surgical margin state with the histopathological diagnosis (LSIL, HSIL or micro-invasive/invasive cancer), menopausal status of the patients, number of pregnancies, surgeon experience, operating time and cone depth. The data was analyzed with the Chi square test, Fisher's exact test for categorical data and Student's T test for continuous data and univariate and multivariate logistical regressions were performed.


RESULTS
A total of 246 medical records have neen analyzed, out of which 29 (11.79%) patients had LSIL, 194 (78.86%) had HSIL and 23 (9.34%) patients suffered micro-invasive/invasive cervical cancer. The surgical margins were positive in 78 (31.7%) of the patients. The average age of the patients was 41.13 and 35 (14.23%) of the patients were menopausal. The multivariate logistic regression identified preoperative forceps biopsy of micro-invasive SCC, HSIL or higher cone specimen histology and shorter cone depth as independent predictors of surgical margin involvement in patients undergoing cold knife conization.


CONCLUSION
In the current study, we have found no association between the inherent characteristics of the patient and the surgeon and the surgical margin state after a CKC. The most important predictors for positive margins were the severity of the lesion and the cone depth.
['Aluloski|Igor|I|', 'Tanturovski|Mile|M|', 'Petrusevska|Gordana|G|', 'Jovanovic|Rubens|R|', 'Kostadinova-Kunovska|Slavica|S|']
D000328:Adult D000368:Aged D019092:Conization D003430:Cross-Sectional Studies D005260:Female D006801:Humans D000072662:Margins of Excision D008875:Middle Aged D060787:Neoplasm Grading D009361:Neoplasm Invasiveness D018843:Republic of North Macedonia D012189:Retrospective Studies D012307:Risk Factors D065310:Squamous Intraepithelial Lesions of the Cervix D016896:Treatment Outcome D002583:Uterine Cervical Neoplasms D055815:Young Adult
surgical margin Cold knife conization residual disease