The appropriate cone depth to avoid endocervical margin involvement is dependent on age and disease severity

Hyo Sook Bae, Ye Won Chung, Tak Kim, Kyu Wan Lee, Jae Yun Song

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Objective. To analyse factors associated with endocervical cone margin involvement and suggest appropriate cone depth for the conization procedure. Design. Retrospective cohort study. Setting. Gynecological oncology center. Population. One thousand two hundred and twenty women undergoing conization for cervical intraepithelial neoplasia (CIN) II or III or stage IA1 microinvasive cervical carcinoma. Methods. The following factors were analysed: age, parity, gravida, conization type, margin status, disease severity and specimen depth. Receiver operating characteristic curve analyses were used to determine the best cut-off points to define appropriate cone depth. Main outcome measures. Cone depth to avoid endecervical margin involvement. Results. Ninety-one women had endocervical margin involvement (7.5%). This was positively associated with disease severity and age and inversely related to cone depth. In women under 50 years of age, the cut-off value was achieved at 1.8 cm cone depth, with high sensitivity and relatively low specificity [area under the curve (AUC) 0.64, sensitivity 0.86, specificity 0.27, p= 0.005]. For a subset of CIN II patients aged ≤50 years, the cut-off value was 1.2 cm (AUC 0.75, sensitivity 0.90, specificity 0.47, p= 0.008). In women <40 years of age, the cut-off value was 1.8 cm (AUC 0.60, sensitivity 0.88, specificity 0.25, p= 0.036). In a subset of CIN II, the cut-off value was 0.9 cm (AUC 0.87, sensitivity 0.83, specificity 0.69, p= 0.002). Conclusions. Age, disease severity and cone depth are predictive factors for endocervical margin involvement. In women of reproductive age, the appropriate cone depth to avoid endocervical margin involvement can be changed depending on age and disease severity.

Original languageEnglish
Pages (from-to)185-192
Number of pages8
JournalActa Obstetricia et Gynecologica Scandinavica
Volume92
Issue number2
DOIs
Publication statusPublished - 2013 Feb 1

Fingerprint

Conization
Cervical Intraepithelial Neoplasia
Area Under Curve
Sensitivity and Specificity
Parity
ROC Curve
Statistical Factor Analysis
Cohort Studies
Retrospective Studies
Outcome Assessment (Health Care)
Carcinoma
Population

Keywords

  • Cervical cone margin
  • cervical intraepithelial neoplasia
  • cervix uteri
  • cone depth
  • conization
  • hysterectomy
  • uterine cervical neoplasm

ASJC Scopus subject areas

  • Obstetrics and Gynaecology

Cite this

The appropriate cone depth to avoid endocervical margin involvement is dependent on age and disease severity. / Bae, Hyo Sook; Chung, Ye Won; Kim, Tak; Lee, Kyu Wan; Song, Jae Yun.

In: Acta Obstetricia et Gynecologica Scandinavica, Vol. 92, No. 2, 01.02.2013, p. 185-192.

Research output: Contribution to journalArticle

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abstract = "Objective. To analyse factors associated with endocervical cone margin involvement and suggest appropriate cone depth for the conization procedure. Design. Retrospective cohort study. Setting. Gynecological oncology center. Population. One thousand two hundred and twenty women undergoing conization for cervical intraepithelial neoplasia (CIN) II or III or stage IA1 microinvasive cervical carcinoma. Methods. The following factors were analysed: age, parity, gravida, conization type, margin status, disease severity and specimen depth. Receiver operating characteristic curve analyses were used to determine the best cut-off points to define appropriate cone depth. Main outcome measures. Cone depth to avoid endecervical margin involvement. Results. Ninety-one women had endocervical margin involvement (7.5{\%}). This was positively associated with disease severity and age and inversely related to cone depth. In women under 50 years of age, the cut-off value was achieved at 1.8 cm cone depth, with high sensitivity and relatively low specificity [area under the curve (AUC) 0.64, sensitivity 0.86, specificity 0.27, p= 0.005]. For a subset of CIN II patients aged ≤50 years, the cut-off value was 1.2 cm (AUC 0.75, sensitivity 0.90, specificity 0.47, p= 0.008). In women <40 years of age, the cut-off value was 1.8 cm (AUC 0.60, sensitivity 0.88, specificity 0.25, p= 0.036). In a subset of CIN II, the cut-off value was 0.9 cm (AUC 0.87, sensitivity 0.83, specificity 0.69, p= 0.002). Conclusions. Age, disease severity and cone depth are predictive factors for endocervical margin involvement. In women of reproductive age, the appropriate cone depth to avoid endocervical margin involvement can be changed depending on age and disease severity.",
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AU - Song, Jae Yun

PY - 2013/2/1

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N2 - Objective. To analyse factors associated with endocervical cone margin involvement and suggest appropriate cone depth for the conization procedure. Design. Retrospective cohort study. Setting. Gynecological oncology center. Population. One thousand two hundred and twenty women undergoing conization for cervical intraepithelial neoplasia (CIN) II or III or stage IA1 microinvasive cervical carcinoma. Methods. The following factors were analysed: age, parity, gravida, conization type, margin status, disease severity and specimen depth. Receiver operating characteristic curve analyses were used to determine the best cut-off points to define appropriate cone depth. Main outcome measures. Cone depth to avoid endecervical margin involvement. Results. Ninety-one women had endocervical margin involvement (7.5%). This was positively associated with disease severity and age and inversely related to cone depth. In women under 50 years of age, the cut-off value was achieved at 1.8 cm cone depth, with high sensitivity and relatively low specificity [area under the curve (AUC) 0.64, sensitivity 0.86, specificity 0.27, p= 0.005]. For a subset of CIN II patients aged ≤50 years, the cut-off value was 1.2 cm (AUC 0.75, sensitivity 0.90, specificity 0.47, p= 0.008). In women <40 years of age, the cut-off value was 1.8 cm (AUC 0.60, sensitivity 0.88, specificity 0.25, p= 0.036). In a subset of CIN II, the cut-off value was 0.9 cm (AUC 0.87, sensitivity 0.83, specificity 0.69, p= 0.002). Conclusions. Age, disease severity and cone depth are predictive factors for endocervical margin involvement. In women of reproductive age, the appropriate cone depth to avoid endocervical margin involvement can be changed depending on age and disease severity.

AB - Objective. To analyse factors associated with endocervical cone margin involvement and suggest appropriate cone depth for the conization procedure. Design. Retrospective cohort study. Setting. Gynecological oncology center. Population. One thousand two hundred and twenty women undergoing conization for cervical intraepithelial neoplasia (CIN) II or III or stage IA1 microinvasive cervical carcinoma. Methods. The following factors were analysed: age, parity, gravida, conization type, margin status, disease severity and specimen depth. Receiver operating characteristic curve analyses were used to determine the best cut-off points to define appropriate cone depth. Main outcome measures. Cone depth to avoid endecervical margin involvement. Results. Ninety-one women had endocervical margin involvement (7.5%). This was positively associated with disease severity and age and inversely related to cone depth. In women under 50 years of age, the cut-off value was achieved at 1.8 cm cone depth, with high sensitivity and relatively low specificity [area under the curve (AUC) 0.64, sensitivity 0.86, specificity 0.27, p= 0.005]. For a subset of CIN II patients aged ≤50 years, the cut-off value was 1.2 cm (AUC 0.75, sensitivity 0.90, specificity 0.47, p= 0.008). In women <40 years of age, the cut-off value was 1.8 cm (AUC 0.60, sensitivity 0.88, specificity 0.25, p= 0.036). In a subset of CIN II, the cut-off value was 0.9 cm (AUC 0.87, sensitivity 0.83, specificity 0.69, p= 0.002). Conclusions. Age, disease severity and cone depth are predictive factors for endocervical margin involvement. In women of reproductive age, the appropriate cone depth to avoid endocervical margin involvement can be changed depending on age and disease severity.

KW - Cervical cone margin

KW - cervical intraepithelial neoplasia

KW - cervix uteri

KW - cone depth

KW - conization

KW - hysterectomy

KW - uterine cervical neoplasm

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