1. Conization before radical hysterectomy in patients with early-stage cervical cancer: A Korean multicenter study (COBRA-R).
- Author
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Kim, Se Ik, Nam, So Hyun, Hwangbo, Suhyun, Kim, Yeorae, Cho, Hyun-Woong, Suh, Dong Hoon, Song, Jae Yun, Kim, Jae-Weon, Choi, Chel Hun, Kim, Dae-Yeon, and Lee, Maria
- Subjects
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TRACHELECTOMY , *CONIZATION , *CERVICAL cancer , *MINIMALLY invasive procedures , *PROPENSITY score matching , *HYSTERECTOMY - Abstract
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. 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 1:1 propensity score matching and compared the survival outcomes between the conization and non-conization groups. 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). 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. • We investigated survival impact of conization before RH on early cervical cancer. • A series of independent sample matching were performed in various patient groups. • Conization lowered relapse of MIS RH in patients with tumors >2 cm but not ≤2 cm. • Conization may be performed before MIS RH to minimize the uterine residual tumor. [ABSTRACT FROM AUTHOR]
- Published
- 2023
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