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  • Title: [The frequency and clinical significance of incomplete removal of epithelial lesions on the cervix uteri by conisation (author's transl)].
    Author: Kraus H, Schuhmann R, Breinl H, Piroth H.
    Journal: Geburtshilfe Frauenheilkd; 1976 May; 36(5):439-44. PubMed ID: 1278664.
    Abstract:
    In cone biopsies of 413 patients we found 394 cases with premalignant or malignant lesions of squamous epithelium. Judged by the examination of the margins of the cone biopsy specimens, the removal of these epithelial lesions was found to be complete in an average of 62,9%. The increasing degree of epithelial atypia correlated with an increasing rate of residual malignant or premalignant tissue. The operation was mostly not radical in the endocervix. In 154 cases subsequent hysterectomia was performed. In 22% of the cases in which the margins of the cone biopsy specimens were free of epithelial changes, residual atypia was discovered in the uterus. On the contrary, in 35% of patients in which residual epithelial atypia was suspected, the uterus was found to be free of malignancy. The reasons are discussed. It is emphasized to pay attention to radical excision especially in the endocervix. Follow-up and smear controls are also necessary when margins of cone biopsy specimen are free of epithelial atypia. In young females desiring further pregnancies, treatment can be left at conisation even if it was not radical; frequent smear controls are obligatory in these cases.
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