Significance of cone biopsy margins in the management of patients with cervical neoplasia.

Too many patients in the United States undergo hysterectomy for cervical neoplasia following cone biopsy because too many gynecologists choose not to pay attention to the pathology present at the margins of the cone specimen. In view of the need to improve the management of cervical neoplasia--i.e., to reduce the number of needless hysterectomies--a retrospective study was done to verify the trend in our institution and to evaluate the utilization of cone biopsy to determine the extent of the process. Also, the methods used for procuring the cone sample and for interpreting the results of the biopsy were studied. The present study included 345 patients who underwent a cone biopsy; subsequently, 102 of them had a hysterectomy. Based on the evaluation of the cases in this study, information was obtained about the performance of cone biopsy and the guidelines for determining when a hysterectomy should be performed and when other, less drastic means of eradicating the neoplasia should be considered.