Correlation of cone biopsy with findings at radical hysterectomy and use of adjuvant radiation therapy

ObjectiveTo determine if pathologic findings in cone biopsy specimens correlate with residual invasive disease in radical hysterectomy specimens and the need for adjuvant chemo-radiation therapy.Study designWe identified 65 patients who underwent a cone biopsy and subsequent radical hysterectomy. Clinico-pathologic parameters in the cone specimens were correlated with the presence of residual invasive disease in the radical hysterectomy specimens and the need for adjuvant chemo-radiation.ResultsA positive endocervical margin, a positive deep margin, a positive post-cone ECC, and positive LVSI were significantly associated with the presence of residual disease in the radical hysterectomy specimen, while positive LVSI, a positive ECC, a positive deep cone margin, and greater than 1 positive margin were significantly associated with the use of adjuvant chemo-radiation therapy.ConclusionPathologic parameters in cone biopsy specimens can estimate the risk of residual invasive disease in radical hysterectomy specimens and the use of adjuvant chemo-radiation.

► Post-cone endocervical curettage is associated with residual disease in radical hysterectomy specimen. ► LVSI and positive ECC are associated with the use of adjuvant chemo-radiation. ► These findings may guide primary treatment decisions.