Acta clinica Croatica, Vol. 63. No. 2, 2024.
Original scientific paper
https://doi.org/10.20471/acc.2024.63.02.5
Positive cone margins – a disadvantage of the large loop excision of transformation zone technique?
Dražan Butorac
; Department of Gynecology and Obstetrics, Sestre milosrdnice University Hospital Center, Zagreb, Croatia
Bernarda Škrtić
; Department of Gynecology and Obstetrics, Sestre milosrdnice University Hospital Center, Zagreb, Croatia
Iva Pitner
orcid.org/0000-0002-5829-5994
; Department of Gynecology and Obstetrics, Sestre milosrdnice University Hospital Center, Zagreb, Croatia
*
Krunoslav Kuna
orcid.org/0000-0002-7119-0070
; Department of Gynecology and Obstetrics, Sestre milosrdnice University Hospital Center, Zagreb, Croatia
Ivka Djaković
orcid.org/0000-0003-2275-6389
; Department of Gynecology and Obstetrics, Sestre milosrdnice University Hospital Center, Zagreb, Croatia
* Corresponding author.
Abstract
The aim was to compare the efficiency of large loop excision of the transformation
zone (LLETZ) and cold-knife conization according to the incidence of positive cone margins in
histopathologic analysis of the cervical cone. In the study, data obtained from 568 female patients
with cone biopsy due to cervical changes during a four-year period (2012-2015) were retrospectively
analyzed. Group 1 included patients who were operated on using LLETZ technique and group 2
consisted of patients with cold-knife cone biopsy. LLETZ was a method of choice in 334 (59%)
patients, whereas 234 (41%) patients underwent cold-knife cone biopsy. The percentage of positive
cone margins was much higher with LLETZ technique, even 39% (131 patients), as compared to
20% with cold-knife cone biopsy. In conclusion, the technique and cone configuration should be
individualized, depending on the specifics of the lesion. The transformation zone is not always removed
during one LLETZ procedure. High percentage of positive cone margins is not a disadvantage of
LLETZ technique because of differences in indications, approach and multiple cutting. The real
success of conization can be measured only by the relapse frequency over a long period of time with a
high number of patients.
Keywords
Conization; Cervical intraepithelial neoplasia; Uterine cervical dysplasia; Uterine cervical cancer
Hrčak ID:
327948
URI
Publication date:
31.10.2025.
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