TY - JOUR
T1 - SUCCOR cone study: conization before radical hysterectomy
AU - Chacon, Enrique
AU - Manzour, Nabil
AU - Zanagnolo, Vanna
AU - Querleu, Denis
AU - Núñez-Córdoba, Jorge M
AU - Martin-Calvo, Nerea
AU - Că Pîlna, Mihai Emil
AU - Fagotti, Anna
AU - Kucukmetin, Ali
AU - Mom, Constantijne
AU - Chakalova, Galina
AU - Shamistan, Aliyev
AU - Gil Moreno, Antonio
AU - Malzoni, Mario
AU - Narducci, Fabrice
AU - Arencibia, Octavio
AU - Raspagliesi, Francesco
AU - Toptas, Tayfun
AU - Cibula, David
AU - Kaidarova, Dilyara
AU - Meydanli, Mehmet Mutlu
AU - Tavares, Mariana
AU - Golub, Dmytro
AU - Perrone, Anna Myriam
AU - Poka, Robert
AU - Tsolakidis, Dimitrios
AU - Vujić, Goran
AU - Jedryka, Marcin A
AU - Zusterzeel, Petra L M
AU - Beltman, Jogchum Jan
AU - Goffin, Frederic
AU - Haidopoulos, Dimitrios
AU - Haller, Herman
AU - Jach, Robert
AU - Yezhova, Iryna
AU - Berlev, Igor
AU - Bernardino, Margarida
AU - Bharathan, Rasiah
AU - Lanner, Maximilian
AU - Maenpaa, Minna M
AU - Sukhin, Vladyslav
AU - Feron, Jean-Guillaume
AU - Fruscio, Robert
AU - Kukk, Kersti
AU - Ponce, Jordi
AU - Minguez, Jose Angel
AU - Vázquez-Vicente, Daniel
AU - Castellanos, Teresa
AU - Boria, Felix
AU - Alcazar, Juan Luis
AU - Chiva, Luis
PY - 2022
Y1 - 2022
N2 - 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.
AB - 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.
KW - cervical cancer
KW - hysterectomy
KW - laparoscopes
KW - laparotomy
KW - surgery
KW - cervical cancer
KW - hysterectomy
KW - laparoscopes
KW - laparotomy
KW - surgery
UR - http://hdl.handle.net/10807/220108
U2 - 10.1136/ijgc-2021-002544
DO - 10.1136/ijgc-2021-002544
M3 - Article
SN - 1525-1438
VL - 32
SP - 117
EP - 124
JO - International Journal of Gynecological Cancer
JF - International Journal of Gynecological Cancer
ER -
