医学
宫颈癌
阶段(地层学)
根治性子宫切除术
宫颈锥切术
子宫切除术
淋巴结
人口
妇科
外科
癌症
产科
宫颈上皮内瘤变
内科学
古生物学
环境卫生
生物
作者
P Gennari,Svetlana N. Tchaikovski,József Mészáros,Michael Gerken,Monika Klinkhammer-Schalke,George Toth,Olaf Ortmann,Holm Eggemann,Atanas Ignatov
标识
DOI:10.1016/j.ygyno.2022.05.014
摘要
The aim of this study was to investigate the impact of pre-operative conization on disease-free survival (DFS) in early-stage cervical cancer.In this population-based cohort study we analysed from clinical cancer registries to determine DFS of women with International Federation of Gynecology and Obstetrics (FIGO) stage IA1-IB1 cervical cancer with respect to conization preceding radical hysterectomy performed between January 2010 and December 2015.Out of 993 datasets available for the analysis, 235 patients met the inclusion criteria of the current study. The median follow-up was 5.4 years. During the study period, 28 (11.9%) recurrences were observed. All of these occurred in patients with FIGO stage IB1. For further evaluation, patients with FIGO IB1 tumors <2 cm were further analysed and divided into two groups, based on pre-operative conization. Pre-operative conization was associated with a reduced rate of recurrence (p = 0.007), with only three (5.2%) recurrences in this group (CO) compared to 25 recurrences (21.0%) in the group without conization (NCO) preceding radical hysterectomy. DFS was estimated at 79.0% and 94.8% in NCO and CO, respectively (p = 0.008). After adjustment for other prognostic covariates, conization remained a favourable prognostic factor for DFS (HR 0.27; 95% CI 0.08-0.93, p = 0.037). Lymph node involvement was the only unfavourable factor (HR 4.38; 95% CI 1.36-14.14, p = 0.014) in the multivariable analysis.Pre-operative conization is associated with improved DFS in early-stage cervical cancer independently of the surgical approach.
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