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373 Protective role of conization before radical hysterectomy in early-stage cervical cancer: a propensity-score matching study
  1. N Bizzarri1,
  2. L Pedone Anchora1,
  3. A Kucukmetin2,
  4. N Ratnavelu2,
  5. P Korompelis2,
  6. MV Carbone1,
  7. C Fedele1,
  8. M Bruno1,
  9. G Vizzielli1,
  10. V Gallotta1,
  11. R De Vincenzo1,
  12. V Chiantera3,
  13. A Fagotti1,
  14. F Fanfani1,
  15. G Ferrandina1 and
  16. G Scambia1
  1. 1Fondazione Policlinico Universitario A. Gemelli, IRCCS, UOC Ginecologia Oncologica, Dipartimento per la salute della Donna e del Bambino e della Salute Pubblica, Italy
  2. 2Northern Gynaecological Oncology Centre, Queen Elizabeth Hospital, UK


3Department of Gynecologic Oncology, ARNAS Ospedali Civico Di Cristina Benfratelli, University of Palermo, Italy

Introduction The aim of this study was to assess the prognostic role and the peri-operative outcomes of conization performed before radical hysterectomy in early-stage cervical carcinoma.

Methods Multi-center retrospective observational cohort study including patients with FIGO 2009 IB1 cervical carcinoma treated with radical hysterectomy between 06/2004 and 06/2019. Patients were divided into two groups according to conization before radical surgery. One-to-one case–control matching was used to adjust the baseline characteristics.

Results 332 patients were included after propensity matching (166, 50% in each group) (table 1). 24/166 (14.4%) and 142/166 (85.6%) conization patients had negative and positive surgical margins on the conization specimen, respectively. No difference in intra- and post-operative complications was noted between the two groups (p=0.542 and p=0.180, respectively). Patients undergoing conization before radical hysterectomy, received less adjuvant treatment (p<0.001) and had a better 5-year disease-free survival (DFS) than patients who did not receive conization (89.8% versus 80.0%, respectively; p=0.010) (figure 1). No difference in 5-year overall survival (OS) (97.1% versus 91.4%, respectively; p=0.114) and in recurrence pattern (p=0.115) was reported between the two groups. Factors significantly independently related to higher risk of recurrence were pathologic tumor diameter >20 mm and no conization before radical hysterectomy (p=0.011 and p=0.018, respectively). The only independent variable influencing OS was pathologic tumor diameter >20 mm (p=0.020).

Abstract 373 Table 1

Comparison of characteristics of patients with or without conization before RH (after propensity match)LVSI: lymph-vascular space involvement; RT: radiotherapy; CT: chemotherapy

Conclusions Conization before radical hysterectomy was associated with improved DFS and lower probability of receiving adjuvant treatment in patients with FIGO-stage IB1 cervical cancer. No difference in peri-operative complications and OS was noted in these groups of patients.

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