[Comparison of the evolution of women with cervical intraepithelial neoplasia degree III treated with cervical cone: negative vs positive surgical margin]

Abstract

Background: Incidence of positive surgical margins in patients submitted to conization is 25%.

Objective: To know the clinical evolution of women with cervical high grade squamous intraepithelial lesion subjected to surgical handling with cervical cone, and expectant handling, comparing positive margins, with negative margins.

Material and methods: We included women subjected to conization for high grade squamous intraepithelial lesion and subsequent expectant handling, in a period of five year. They were included in two groups: I. Patients with negative margins and II. Patients with positive margins. Cure approaches settled down with two cytologic-colposcopic negative controls; persistence, when the first control was positive and recurrence, when some appeared positive after two negatives. It was used binomial analysis and square Chi.

Results: Forty-seven women were studied with conization; 10 of positive margins and 37 of negative. In the group with positive margins there were eight cures (80%) and two recurrences (20%); while in the group of negative margins there were 35 cures (94%) and two recurrences (6%). There was not significant difference in both groups (p > 0.05).

Conclusions: The expectant handling is a good alternative in patients subjected to conization with positive margins, since it is high the percentage of spontaneous regression of the lesion.