Does a pre-operative conization improve disease-free survival in early-stage cervical cancer?
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GYNECOLOGIC ONCOLOGY
Does a pre‑operative conization improve disease‑free survival in early‑stage cervical cancer? Louise Benoit1 · Meriem Koual1,2,3 · Huyen‑Thu Nguyen‑Xuan1,2 · Vincent Balaya1,2 · Claude Nos1 · Rosa Montero‑Macías1 · Anne‑Sophie Bats1,2,4 Received: 12 May 2020 / Accepted: 11 September 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purpose Ever since the recent findings showing the lack of benefit of minimally invasive surgery (MIS) versus open surgery in early-stage cervical cancer, gynecologists have tried to explain these results. The primary objective of our study was to assess the impact of pre-operative conization on disease-free survival (DFS) in early-stage cervical cancer. The secondary objective was to analyze the peri-operative morbidity associated with a pre-operative conization. Methods All patients undergoing a surgical management for early-stage squamous carcinoma or adenocarcinoma cervical cancer (IA1, IA2, IB1 and IB2 FIGO 2018) at a French university hospital from 2004 to 2018 were retrospectively included. We examined the association between conization and DFS using a Cox regression model. We also analyzed the morbidity associated with pre-operative conization. Results 48.4% (44/91) of the patients had a pre-operative conization (defined by a conization up to 90 days prior to surgery). 86.8% underwent MIS. There was a non-significant increase in the DFS with one patient presenting a recurrence in the conization group (2.3%) and six (12.8%) in the no conization group (log rank = 0.09). In univariate analysis, conization, definitive FIGO stage and pre-operative tumor size were associated with DFS (p
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