Repeat Conisation of the cervix is indicated after primary treatments with positive stromal margins or to assess the extent of previously unsuspected invasive or glandular disease diagnosed on the primary specimen.

It is well recognised that repeat conisation has significant consequences both for younger women planning fertility, and older women for whom repeat procedures may be technically difficult and associated with an increased risk of complications. Detailed examination of women requiring second procedures and identification of features predictive for residual disease may assist in reducing this occurrence.

Studies have suggested that the rate of residual disease on second conisation is around 46% for squamous microinvasive disease and up to 68% in adenocarcinoma in situ (ACIS) with positive margins[1] [2]. Previously reported risk factors for residual disease include; the use of LLETZ vs cold-knife conisation, post-menopausal status, larger primary lesion areas and the depth of the primary excision[3]. The local experience in Australia, however, has not been well described and may differ due to the more common use of colposcopy and LLETZ procedures by general gynaecologists.

In Tasmania, the majority of second procedures are referred to a centralised colposcopy review process and thus the state wide data is available. In this retrospective review the rates of residual disease in repeat cervical conisations as well as the characteristics of the patient and primary specimen from 2012 to 2016 will be described. The implications for treatment recommendations will be discussed.