Conization before radical hysterectomy in patients with early-stage cervical cancer: A Korean multicenter study (COBRA-R).
Gynecol Oncol
; 173: 88-97, 2023 06.
Article
em En
| MEDLINE
| ID: mdl-37105062
ABSTRACT
OBJECTIVE:
To investigate the impact of conization on survival outcomes and to identify a specific population that might benefit from conization before radical hysterectomy (RH) in patients with early-stage cervical cancer.METHODS:
From six institutions in Korea, we identified node-negative, margin-negative, parametria-negative, 2009 FIGO stage IB1 cervical cancer patients who underwent primary type C RH between 2006 and 2021. The patients were divided into multiple groups based on tumor size, surgical approach, and histology. We performed a series of independent 11 propensity score matching and compared the survival outcomes between the conization and non-conization groups.RESULTS:
In total, 1254 patients were included conization (n = 355) and non-conization (n = 899). Among the matched patients with a tumor size of >2 cm, the conization group showed a significantly better 3-year disease-free survival (DFS) rate compared with the non-conization group when RH was conducted via minimally invasive surgery (MIS), in those with squamous cell carcinoma (96.3% vs. 87.4%, P = 0.007) and non-squamous cell carcinoma (97.0% vs. 74.8%, P = 0.021). However, no difference in DFS was observed between the two groups among the matched patients with a tumor size of ≤2 cm, regardless of surgical approach or histological type. In patients who underwent MIS RH, DFS significantly worsened as the residual tumor size increased (P < 0.001).CONCLUSION:
Cervical conization was associated with a lower recurrence rate in patients with early-stage cervical cancer with a tumor size of >2 cm who underwent primary MIS RH. Cervical conization may be performed prior to MIS RH to minimize the uterine residual tumor.Palavras-chave
Texto completo:
1
Bases de dados:
MEDLINE
Assunto principal:
Carcinoma de Células Escamosas
/
Neoplasias do Colo do Útero
Tipo de estudo:
Clinical_trials
/
Observational_studies
/
Prognostic_studies
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Risk_factors_studies
Limite:
Female
/
Humans
País/Região como assunto:
Asia
Idioma:
En
Revista:
Gynecol Oncol
Ano de publicação:
2023
Tipo de documento:
Article