Margin status of conization specimens obtained by see-and-treat strategy and three-step strategy

Purpose: To evaluate the margin status of conization specimens according to treatment strategy. Materials and Methods: A retrospective review was performed for patients who underwent conization at a single institution from January 2003 to August 2012. Cases were divided into two groups depending on whether the patient had undergone a punch biopsy before conization or not (the ‘see-andtreat’ group or the ‘three-step’ group). The final histologic results of the two groups were compared. Results: Of the 862 patients, 694 women were in the ‘see-and-treat’ group and 168 women were in the ‘three-step’ group. There was no significant statistical difference in the rate of cone margin involvement between the two groups. However, the cone margin involvement rate of patients with CIN 3 was higher in the ‘see-and-treat’ group (26.5% in the ‘see-and-treat’ group vs. 11.7% in the ‘three-step’ group; p = 0.012). When patients with HSIL cytology were subanalyzed, ‘see-and-treat’ group with CIN 3 had a trend toward high cone margin involvement rate than three-step group without statistical significance (24.4% in the ‘see-and-treat’ group vs. 9.0% in the ‘three-step’ group; p = 0.053). Conclusion: Without inspection of cervical precancerous lesion, the patients with high-grade squamous intraepithelial lesion (HSIL) treated by ‘see-and-treat’ strategy are more likely to show positive cone margin involvement.

Cervical intraepithelial neoplasia; Conization; HSIL; ‘See-and-treat’ strategy; Positive margin.

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