Excisions of severe cervical dysplasia: Are there mandatory diameters of the cone that need to be considered?

Objective: to achieve optimal depth for negative margin cones after loop electrosurgical excision procedures (leep) for cervical dysplasia. material and methods: retrospective cohort analysis of leep cones of 201 patients with cervical dysplasia during a four-year period. analysed cones were divided into two different groups: cones with negative margins without dysplasia,and cones with margins positive for dysplasia. in order to determine the cut-off value of the depth of the resected cones,receiver operating characteristic (roc) analysis was performed. results: negative margins were found in 71.0% (n=49) of all cones,whereas positive margins were reported in 29.0% (n=20). negative margin cones were achieved in 100% with a cone depth of ≥20 mm. a resection depth between 10-19.9 mm led to 73.0% negative margin cones. calculation of cone volume shows for 2.0 cm 3,a sensitivity of 79% and a specificity of 64%. statistical analysis using an roc model showed p=0.002. conclusion: forth greatest safety of patients,cone depths from leeps for cervical dysplasia should be ≥20 mm to achieve negative margins. © 2017 by the turkish-german gynecological education and research foundation.