The Role of Conization before Radical Hysterectomy in Cervical Cancer including High Risk Factors of Recurrence: Propensity Score Matching
We primarily aimed to investigate the therapeutic role of conization prior to radical hysterectomy for cervical cancer. Secondarily, we aimed to characterize a subgroup of patients who could potentially benefit from preoperative conization. Patients who underwent radical hysterectomy for FIGO 2009 s...
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2022-08-01
|
| Series: | Cancers |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2072-6694/14/16/3863 |
| _version_ | 1797446619308752896 |
|---|---|
| author | Chi-Son Chang Ji Song Min Ki Hyeon Song Chel Hun Choi Tae-Joong Kim Jeong-Won Lee Byoung-Gie Kim Yoo-Young Lee |
| author_facet | Chi-Son Chang Ji Song Min Ki Hyeon Song Chel Hun Choi Tae-Joong Kim Jeong-Won Lee Byoung-Gie Kim Yoo-Young Lee |
| author_sort | Chi-Son Chang |
| collection | DOAJ |
| description | We primarily aimed to investigate the therapeutic role of conization prior to radical hysterectomy for cervical cancer. Secondarily, we aimed to characterize a subgroup of patients who could potentially benefit from preoperative conization. Patients who underwent radical hysterectomy for FIGO 2009 stage IB1 to IIB cervical cancer from 1995 to 2020 were eligible. The patients were divided into two groups: those with and without preoperative conization. To adjust for the baseline characteristics of the two groups, 1:2 case–control propensity score matching was conducted. Survival analysis was performed between the two groups. Subgroup analysis was performed to identify the effect of conization based on clinical and pathological factors. Patients who underwent preoperative conization showed better 5-year overall survival than those who did not (95.9% vs. 93.0%, <i>p</i> = 0.029); however, no difference was observed in progression-free survival (88.9% vs. 85.9%, <i>p</i> = 0.155). In multivariate Cox analysis, conization showed a 55% reduction in recurrence (hazard ratio (HR) 0.65, 95% confidence interval (CI) 0.41–1.01, <i>p</i> = 0.056) and 41% reduction in death (HR 0.59, 95% CI 0.34–1.02, <i>p</i> = 0.059), but with marginal statistical significance. In subgroup analysis, minimally invasive surgery (MIS), negative pelvic lymph node, and tumor size < 4 cm showed improved survival from conization. Conization before radical hysterectomy may be associated with improved survival in patients with early-stage cervical cancer. This information could serve as a basis for a more tailored patient selection for MIS for cervical cancer. |
| first_indexed | 2024-03-09T13:43:13Z |
| format | Article |
| id | doaj.art-5d7bc708205c46aeb8db0d29a7b056c8 |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-09T13:43:13Z |
| publishDate | 2022-08-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-5d7bc708205c46aeb8db0d29a7b056c82023-11-30T21:03:37ZengMDPI AGCancers2072-66942022-08-011416386310.3390/cancers14163863The Role of Conization before Radical Hysterectomy in Cervical Cancer including High Risk Factors of Recurrence: Propensity Score MatchingChi-Son Chang0Ji Song Min1Ki Hyeon Song2Chel Hun Choi3Tae-Joong Kim4Jeong-Won Lee5Byoung-Gie Kim6Yoo-Young Lee7Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, KoreaDepartment of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, KoreaDepartment of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, KoreaDepartment of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, KoreaDepartment of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, KoreaDepartment of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, KoreaDepartment of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, KoreaDepartment of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, KoreaWe primarily aimed to investigate the therapeutic role of conization prior to radical hysterectomy for cervical cancer. Secondarily, we aimed to characterize a subgroup of patients who could potentially benefit from preoperative conization. Patients who underwent radical hysterectomy for FIGO 2009 stage IB1 to IIB cervical cancer from 1995 to 2020 were eligible. The patients were divided into two groups: those with and without preoperative conization. To adjust for the baseline characteristics of the two groups, 1:2 case–control propensity score matching was conducted. Survival analysis was performed between the two groups. Subgroup analysis was performed to identify the effect of conization based on clinical and pathological factors. Patients who underwent preoperative conization showed better 5-year overall survival than those who did not (95.9% vs. 93.0%, <i>p</i> = 0.029); however, no difference was observed in progression-free survival (88.9% vs. 85.9%, <i>p</i> = 0.155). In multivariate Cox analysis, conization showed a 55% reduction in recurrence (hazard ratio (HR) 0.65, 95% confidence interval (CI) 0.41–1.01, <i>p</i> = 0.056) and 41% reduction in death (HR 0.59, 95% CI 0.34–1.02, <i>p</i> = 0.059), but with marginal statistical significance. In subgroup analysis, minimally invasive surgery (MIS), negative pelvic lymph node, and tumor size < 4 cm showed improved survival from conization. Conization before radical hysterectomy may be associated with improved survival in patients with early-stage cervical cancer. This information could serve as a basis for a more tailored patient selection for MIS for cervical cancer.https://www.mdpi.com/2072-6694/14/16/3863conizationcervical cancerradical hysterectomyprognosispropensity score matching |
| spellingShingle | Chi-Son Chang Ji Song Min Ki Hyeon Song Chel Hun Choi Tae-Joong Kim Jeong-Won Lee Byoung-Gie Kim Yoo-Young Lee The Role of Conization before Radical Hysterectomy in Cervical Cancer including High Risk Factors of Recurrence: Propensity Score Matching Cancers conization cervical cancer radical hysterectomy prognosis propensity score matching |
| title | The Role of Conization before Radical Hysterectomy in Cervical Cancer including High Risk Factors of Recurrence: Propensity Score Matching |
| title_full | The Role of Conization before Radical Hysterectomy in Cervical Cancer including High Risk Factors of Recurrence: Propensity Score Matching |
| title_fullStr | The Role of Conization before Radical Hysterectomy in Cervical Cancer including High Risk Factors of Recurrence: Propensity Score Matching |
| title_full_unstemmed | The Role of Conization before Radical Hysterectomy in Cervical Cancer including High Risk Factors of Recurrence: Propensity Score Matching |
| title_short | The Role of Conization before Radical Hysterectomy in Cervical Cancer including High Risk Factors of Recurrence: Propensity Score Matching |
| title_sort | role of conization before radical hysterectomy in cervical cancer including high risk factors of recurrence propensity score matching |
| topic | conization cervical cancer radical hysterectomy prognosis propensity score matching |
| url | https://www.mdpi.com/2072-6694/14/16/3863 |
| work_keys_str_mv | AT chisonchang theroleofconizationbeforeradicalhysterectomyincervicalcancerincludinghighriskfactorsofrecurrencepropensityscorematching AT jisongmin theroleofconizationbeforeradicalhysterectomyincervicalcancerincludinghighriskfactorsofrecurrencepropensityscorematching AT kihyeonsong theroleofconizationbeforeradicalhysterectomyincervicalcancerincludinghighriskfactorsofrecurrencepropensityscorematching AT chelhunchoi theroleofconizationbeforeradicalhysterectomyincervicalcancerincludinghighriskfactorsofrecurrencepropensityscorematching AT taejoongkim theroleofconizationbeforeradicalhysterectomyincervicalcancerincludinghighriskfactorsofrecurrencepropensityscorematching AT jeongwonlee theroleofconizationbeforeradicalhysterectomyincervicalcancerincludinghighriskfactorsofrecurrencepropensityscorematching AT byounggiekim theroleofconizationbeforeradicalhysterectomyincervicalcancerincludinghighriskfactorsofrecurrencepropensityscorematching AT yooyounglee theroleofconizationbeforeradicalhysterectomyincervicalcancerincludinghighriskfactorsofrecurrencepropensityscorematching AT chisonchang roleofconizationbeforeradicalhysterectomyincervicalcancerincludinghighriskfactorsofrecurrencepropensityscorematching AT jisongmin roleofconizationbeforeradicalhysterectomyincervicalcancerincludinghighriskfactorsofrecurrencepropensityscorematching AT kihyeonsong roleofconizationbeforeradicalhysterectomyincervicalcancerincludinghighriskfactorsofrecurrencepropensityscorematching AT chelhunchoi roleofconizationbeforeradicalhysterectomyincervicalcancerincludinghighriskfactorsofrecurrencepropensityscorematching AT taejoongkim roleofconizationbeforeradicalhysterectomyincervicalcancerincludinghighriskfactorsofrecurrencepropensityscorematching AT jeongwonlee roleofconizationbeforeradicalhysterectomyincervicalcancerincludinghighriskfactorsofrecurrencepropensityscorematching AT byounggiekim roleofconizationbeforeradicalhysterectomyincervicalcancerincludinghighriskfactorsofrecurrencepropensityscorematching AT yooyounglee roleofconizationbeforeradicalhysterectomyincervicalcancerincludinghighriskfactorsofrecurrencepropensityscorematching |