OBJECTIVE: To evaluate disease-free survival of cervical conization prior to radical hysterectomy in patients with stage IB1 cervical cancer (International Federation of Gynecology and Obstetrics (FIGO) 2009). METHODS: A multicenter retrospective observational cohort study was conducted including patients from the Surgery in Cervical Cancer Comparing Different Surgical Aproaches in Stage IB1 Cervical Cancer (SUCCOR) database with FIGO 2009 IB1 cervical carcinoma treated with radical hysterectomy between January 1, 2013, and December 31, 2014. We used propensity score matching to minimize the potential allocation biases arising from the retrospective design. Patients who underwent conization but were similar for other measured characteristics were matched 1:1 to patients from the non-cone group using a caliper width ≤0.2 standard deviations of the logit odds of the estimated propensity score. RESULTS: We obtained a weighted cohort of 374 patients (187 patients with prior conization and 187 non-conization patients). We found a 65% reduction in the risk of relapse for patients who had cervical conization prior to radical hysterectomy (hazard ratio (HR) 0.35, 95% confidence interval (CI) 0.16 to 0.75, p=0.007) and a 75% reduction in the risk of death for the same sample (HR 0.25, 95% CI 0.07 to 0.90, p=0.033). In addition, patients who underwent minimally invasive surgery without prior conization had a 5.63 times higher chance of relapse compared with those who had an open approach and previous conization (HR 5.63, 95% CI 1.64 to 19.3, p=0.006). Patients who underwent minimally invasive surgery with prior conization and those who underwent open surgery without prior conization showed no differences in relapse rates compared with those who underwent open surgery with prior cone biopsy (reference) (HR 1.94, 95% CI 0.49 to 7.76, p=0.349 and HR 2.94, 95% CI 0.80 to 10.86, p=0.106 respectively). CONCLUSIONS: In this retrospective study, patients undergoing cervical conization before radical hysterectomy had a significantly lower risk of relapse and death.

• Klíčová slova
• cervical cancer, hysterectomy, laparoscopes, laparotomy, surgery,
• MeSH
• databáze faktografické MeSH
• dospělí MeSH
• hysterektomie statistika a číselné údaje   MeSH
• konizace děložního čípku statistika a číselné údaje   MeSH
• lidé středního věku MeSH
• lidé MeSH
• lokální recidiva nádoru prevence a kontrola   MeSH
• miniinvazivní chirurgické výkony MeSH
• nádory děložního čípku patologie   chirurgie   MeSH
• přežití bez známek nemoci MeSH
• retrospektivní studie MeSH
• tendenční skóre MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• multicentrická studie MeSH
• pozorovací studie MeSH

• Klíčová slova
• CERVIX UTERI/surgery *,
• MeSH
• cervix uteri chirurgie   MeSH
• konizace děložního čípku * MeSH
• lidé MeSH
• Check Tag
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

Peroperative haemorrhage is a frequent complication of conization of the portio uteri by surgery-by a "cold knife" scalpel or another method (LEEP, laser, etc.). In a clinical study comprising 41 patients with the diagnosis CIN I-III or laceration of the portio uteri classical conization by means of a scalpel was made with concurrent haemostasis with terlipressin (TLP) by paracervical administration (400 micrograms-REMESTYP 2 amp.). Concurrently the blood loss in ml was followed, the Hb level and other effects of the preparation. From the results ensues that side-effects after local administration of TLP were observed only in 12.2%. Peroperative blood losses were on average under 15 ml. Local paracervical TLP administration appears effective from the clinical aspect with regard to the low frequency of side-effects and the favourable haemostatic effect.

• MeSH
• cervix uteri chirurgie   MeSH
• dysplazie děložního hrdla chirurgie   MeSH
• hemostáza chirurgická MeSH
• konizace děložního čípku * MeSH
• krvácení při operaci prevence a kontrola   MeSH
• lidé MeSH
• lypresin aplikace a dávkování   analogy a deriváty   MeSH
• nádory děložního čípku chirurgie   MeSH
• terlipresin MeSH
• vagina chirurgie   MeSH
• Check Tag
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• lypresin MeSH
• terlipresin MeSH

• MeSH
• cervix uteri chirurgie   MeSH
• dospělí MeSH
• hemostáza chirurgická * MeSH
• konizace děložního čípku * MeSH
• lidé středního věku MeSH
• lidé MeSH
• lypresin škodlivé účinky   analogy a deriváty   MeSH
• terlipresin MeSH
• vazokonstriktory aplikace a dávkování   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• klinické zkoušky MeSH
• randomizované kontrolované studie MeSH
• Názvy látek
• lypresin MeSH
• terlipresin MeSH
• vazokonstriktory MeSH

• Klíčová slova
• CERVIX NEOPLASMS *, NEOPLASM DIAGNOSIS *, SURGERY, OPERATIVE *,
• MeSH
• chirurgie operační * MeSH
• konizace děložního čípku * MeSH
• lidé MeSH
• nádory děložního čípku * MeSH
• nádory diagnóza   MeSH
• Check Tag
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

• MeSH
• cervix uteri patologie   MeSH
• cytodiagnostika normy   MeSH
• konizace děložního čípku * MeSH
• lidé MeSH
• nádory děložního čípku diagnóza   patologie   MeSH
• vaginální stěr MeSH
• Check Tag
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

OBJECTIVE: The aim of our study was to describe oncological and obstetrical outcomes in patients who underwent less radical fertility-sparing surgical (FSS) procedures with omitted parametrectomy for cervical cancer. METHODS: Included were women with cervical cancer stages IA2-IB2 who were under the age of 40 and desired future pregnancy. Patients underwent pelvic lymphadenectomy and sentinel lymph node biopsy. Node-negative cases underwent subsequent cervical surgery and were further analyzed. Neoadjuvant chemotherapy (NAC) was administered in patients with tumors >2cm and/or involving >2/3 of cervical stroma. Simple vaginal trachelectomy or needle conization were performed according to tumor extent and topography. The follow-up period started once free surgical margins were reached. RESULTS: Out of 44 women enrolled, 32 women (IA2=7, IB1=23, IB2=2) successfully completed FSS. NAC was administered in 9 (28.1%) cases. A simple trachelectomy was performed in 11 patients and needle conization in 21 patients. During the follow-up, 6 out of 32 women became pregnant. Of these, 1 miscarried and 5 successfully delivered. Disease recurred in 6 patients; 5 recurrences were central and 1 recurrence presented as an ovarian mass. Invasive cervical carcinoma, high-grade squamous intraepithelial (HSIL), and low-grade squamous intraepithelial (LSIL) lesions were detected in 4, 1 and 1 patients, respectively. Three of them received NAC. All events were detected within 16months after surgery. CONCLUSIONS: Nearly 27% of patients cannot complete FSS due to node positivity, progression during NAC, or involved margins. The total recurrence rate reached 18.8%, with the majority of invasive recurrences detected in patients after NAC followed by FSS. These patients represent cases at a higher risk of recurrence even if adequate free margins are reached by surgery. Nearly half of the cohort did not consider pregnancy in the near future because of personal reasons.

• Klíčová slova
• Cervical cancer, Conization, Fertility-sparing surgery, Trachelectomy,
• MeSH
• adjuvantní chemoterapie MeSH
• dospělí MeSH
• konizace děložního čípku metody   MeSH
• lidé MeSH
• mladý dospělý MeSH
• nádory děložního čípku farmakoterapie   patologie   chirurgie   MeSH
• neoadjuvantní terapie MeSH
• retrospektivní studie MeSH
• těhotenství MeSH
• trachelektomie metody   MeSH
• zachování plodnosti metody   MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mladý dospělý MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

• MeSH
• cervix uteri chirurgie   MeSH
• elektrokoagulace metody   MeSH
• lidé MeSH
• vysoká teplota MeSH
• Check Tag
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

The main aim of our study was to investigate the specific contribution of a 9-valent human papillomavirus vaccine (9vHPV) to the recurrence risk of cervical intraepithelial neoplasia grade 2 or worse (CIN2+) in women vaccinated post-excision. Therefore, we conducted a retrospective monocentric cohort study in women aged 22-49 years undergoing conization between 2014 and 2023. The 9vHPV-vaccinated women were matched to unvaccinated women for age and follow-up duration in a 1:2 ratio to eliminate allocation bias. The risk of CIN2+ recurrence was estimated by the incidence rate ratio using Poisson regression with adjustment for comorbidities, smoking status, nulliparity, CIN grade, positive cone margin, and HPV genotypes. The CIN2+ recurrence rates in 147 women enrolled in the analysis were 18 and 2 cases per 100,000 person-days for unvaccinated and vaccinated women, respectively, during a mean follow-up period of 30 months (±22 months). A reduction in CIN2+ recurrences by 90% (95% confidence interval: 12-99%) was documented in 9vHPV-vaccinated participants compared to women undergoing only surgical excision. Moreover, vaccinated women with a positive cone margin showed a 42% (though non-significant) reduction in relapse (p = .661). Full post-conization vaccination with the 9vHPV contributed to an additional reduction in the risk of CIN2+ recurrence. This finding is consistent with current knowledge and suggests a high adjuvant effect of the 9vHPV vaccine.

• Klíčová slova
• Human papillomavirus, cervical intraepithelial neoplasia, conization, recurrence reduction, vaccination,
• MeSH
• dospělí MeSH
• dysplazie děložního hrdla * prevence a kontrola   virologie   MeSH
• infekce papilomavirem * prevence a kontrola   MeSH
• konizace děložního čípku metody   MeSH
• lidé středního věku MeSH
• lidé MeSH
• lokální recidiva nádoru * prevence a kontrola   MeSH
• mladý dospělý MeSH
• nádory děložního čípku * prevence a kontrola   virologie   MeSH
• retrospektivní studie MeSH
• vakcinace MeSH
• vakcíny proti papilomavirům * aplikace a dávkování   imunologie   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladý dospělý MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Názvy látek
• vakcíny proti papilomavirům * MeSH

• MeSH
• cervix uteri chirurgie   MeSH
• lidé MeSH
• metody MeSH
• nemoci cervix uteri chirurgie   MeSH
• Check Tag
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH