Introduction/Background Cone biopsy is sometimes performed before surgical treatment for early stage cervical cancer disease. The purpose of this work is to evaluate if cone biopsy modifies the characteristics of the tumor in the final surgical specimen and influences the decision for adjuvant radiotherapy. The final outcome evaluated will be the tumors´ recurrence.

Methodology Retrospective Analysis of 417 cases of early stage cervical cancer disease, treated in one tertiary center between 2005–2015. Data was assorted in 2 subgroups: Group 1 – women with diagnosis made by cone biopsy (n=179); Group 2 – women with diagnosis made by biopsy (n = 232) . SPSS was used for data analysis. The differences between tumor size and proportion of cervical invasion were evaluated by student´s T test. Fisher´s exact test (two tailed) was used for evaluating the other tumors parameters and the proportion of women who underwent adjuvant therapy and disease recurrence.

Results After cone biopsy, tumor size present at surgical specimen is smaller, (mean 26 vs 19 mm, p< 0.001), but the proportion of cervical stromal invasion was similar between groups (mean 0.66 vs 0.56 p=0.58). Less women underwent adjuvant therapy in group with diagnosis made by cone biopsy (23% vs 52% p< 0.001). Disease recurrence was similar between the two groups evaluated separately for women who underwent adjuvant therapy (n=41, women with cone biopsy 7.3% vs women without cone biopsy 17%, p=0.2) or just vigilance (n= 137, women with cone biopsy 4.4% vs women without cone biopsy 8.5%, p=0.19).

Conclusion Women that performed cone biopsy underwent adjuvant therapy less frequently, without increasing the recurrence rate – Cone biopsy seems to be protective.