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SUCCOR cone study: conization before radical hysterectomy

International journal of gynecological cancer. 2022 Feb ; 32 (2) : 117-124. [epub] 20220117

Int J Gynecol Cancer
ISSN 1525-1438 | 1048-891X
Source

Language English Country United States Media print-electronic

Document type Journal Article, Multicenter Study, Observational Study

Persistent link https://www.medvik.cz/link/pmid35039455

PubMed 35039455
DOI 10.1136/ijgc-2021-002544
PII: S1048-891X(24)00567-X
Knihovny.cz E-resources

Keywords
cervical cancer, hysterectomy, laparoscopes, laparotomy, surgery,
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.

SUCCOR cone study: conization before radical hysterectomy

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