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SUCCOR cone study: conization before radical hysterectomy
E. Chacon, N. Manzour, V. Zanagnolo, D. Querleu, JM. Núñez-Córdoba, N. Martin-Calvo, ME. Căpîlna, A. Fagotti, A. Kucukmetin, C. Mom, G. Chakalova, A. Shamistan, A. Gil Moreno, M. Malzoni, F. Narducci, O. Arencibia, F. Raspagliesi, T. Toptas, D....
Language English Country Great Britain
Document type Journal Article, Multicenter Study, Observational Study
NLK
ProQuest Central
from 2018-01-01 to 6 months ago
Health & Medicine (ProQuest)
from 2018-01-01 to 6 months ago
- MeSH
- Databases, Factual MeSH
- Adult MeSH
- Hysterectomy statistics & numerical data MeSH
- Conization statistics & numerical data MeSH
- Middle Aged MeSH
- Humans MeSH
- Neoplasm Recurrence, Local prevention & control MeSH
- Minimally Invasive Surgical Procedures MeSH
- Uterine Cervical Neoplasms pathology surgery MeSH
- Disease-Free Survival MeSH
- Retrospective Studies MeSH
- Propensity Score MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Multicenter Study MeSH
- Observational Study MeSH
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.
Amsterdam University Medical Centres Amsterdam Noord Holland Netherlands
Azienda Ospedaliero Universitaria di Bologna Policlinico SantOrsola Malpighi Bologna Italy
Bellvitge University Hospital L'Hospitalet de Llobregat Catalunya Spain
Clinic of Obstetrics and Gynecology Hospital San Gerardo Monza Italy
Clinica Universidad de Navarra Departamento de Ginecologia y Obstetricia Madrid Spain
Clinica Universidad de Navarra Departamento de Ginecologia y Obstetricia Pamplona Navarra Spain
Clinica Universidad de Navarra Pamplona Navarra Spain
Clinical Hospital Center Rijeka Rijeka Croatia
Clinical Hospital Center Zagreb Croatia
Department of Gynecology and Oncology Jagiellonian University Krakow Poland
Department of Gynecology Centre Oscar Lambret Lille France
Department of Medicine and Surgery University of Milan Bicocca Milano Italy
Department of Obstetrics and Gynecology University of Prague Prague Czech Republic
Department of Preventive Medicine and Public Health Universidad de Navarra Pamplona Spain
Department of Surgery LISOD Israeli Oncological Hospital Kyiv Ukraine
Emergency County Hospital Targu Mures Targu Mures Romania
General Hospital of Thessaloniki Papageorgiou Thessaloniki Central Macedonia Greece
Gynaecology LUMC Leiden Netherlands
Gynecologic Oncology Universidad de Navarra Pamplona Navarra Spain
Gynecological Oncology Radboudumc Nijmegen Netherlands
Gynecology Clinica Universitaria de Navarra Madrid Spain
Gynecology Clinica Universitaria de Navarra Pamplona Navarra Spain
Gynecology Instituto Português de Oncologia de Lisboa Lisboa Lisboa Portugal
Gynecology Vall d'Hebron Hospital Sant Cugat Del Vallés Barcelona Spain
Institut Curie Paris Île de France France
IPO PORTO Porto Porto Portugal
Istituto Europeo di Oncologia Milano Anognnn Italy
Kardinal Schwarzenberg'sches Krankenhaus Schwarzach Steiermark Austria
Lviv Oncology Center Lviv Ukraine
National Center of Oncology Baku Azerbaijan
North Estonia Medical Centre Tallinn Estonia
Obstetrics and Gynecology Clinica Universidad de Navarra Madrid Spain
Obstetrics and Gynecology School of Medicine University of Navarra Pamplona Spain
Obstetrics and Gynecology Tampere University Hospital Tampere Finland
Obstetrics and Gynecology University of Liege Liege Belgium
Oncogynecology Grigorev Institute for Radiology Kharkiv Ukraine
Oncogynecology Kazahskij Naucno issledovatel'skij Institut Onkologii i Radiologii Almaty Kazakhstan
Oncological Gynecology Lower Silesian Cancer Center Wroclaw Poland
Queen Elizabeth Hospital Gateshead Gateshead UK
Surgery Fondazione IRCCS Istituto Nazionale dei Tumori Milano Lombardia Italy
Surgery Institut Bergonie Bordeaux France
Universitat Autònoma de Barcelona Barcelona Barcelona Spain
University Hospital Agostino Gemelli Gynaecological Oncology Complex Operative Unit Roma Lazio Italy
University Hospitals of Leicester NHS Trust Leicester Leicester UK
References provided by Crossref.org
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- $a SUCCOR cone study: conization before radical hysterectomy / $c E. Chacon, N. Manzour, V. Zanagnolo, D. Querleu, JM. Núñez-Córdoba, N. Martin-Calvo, ME. Căpîlna, A. Fagotti, A. Kucukmetin, C. Mom, G. Chakalova, A. Shamistan, A. Gil Moreno, M. Malzoni, F. Narducci, O. Arencibia, F. Raspagliesi, T. Toptas, D. Cibula, D. Kaidarova, MM. Meydanli, M. Tavares, D. Golub, AM. Perrone, R. Poka, D. Tsolakidis, G. Vujić, MA. Jedryka, PLM. Zusterzeel, JJ. Beltman, F. Goffin, D. Haidopoulos, H. Haller, R. Jach, I. Yezhova, I. Berlev, M. Bernardino, R. Bharathan, M. Lanner, MM. Maenpaa, V. Sukhin, JG. Feron, R. Fruscio, K. Kukk, J. Ponce, JA. Minguez, D. Vázquez-Vicente, T. Castellanos, F. Boria, JL. Alcazar, L. Chiva, SUCCOR study group, SUCCOR study Group
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- $a 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.
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