Introduction/Background*We aimed to identify characteristics of a cone biopsy that may independently predict higher odds of positive nodes.
Methodology We used data from the SUCCOR study, a European multicentre study that collected retrospective information of 1272 women who underwent a radical hysterectomy by open or minimally invasive surgery for stage IB1 cervical cancer (FIGO 2009) between January 2013 and December 2014. We restricted the analyses to 423 who underwent a cone biopsy. Missing values were imputed with the median in quantitative variable and grouped in a new category in qualitative ones. Univariate analysis was carried out to identify those variables related to the cone biopsy that were significantly related to nodal status. We used Student’s t test for quantitative variables and Pearson’s chi squared test for qualitative ones. Variables with a p value below 0.05 in the univariate analyses were introduced in a multivariable adjusted logistic regression.
Result(s)*In the univariate analyses we found that large tumours (> 2 cm) and squamous or adenosquamous histopathology were associated with higher odds of positive nodes. Regarding characteristics of the cone biopsy, we observed that deep stroma invasion (2/3 of stroma) and positive margins were also associated with higher odds of positive nodes. In the multivariable adjusted model, we observed collinearity between the characteristics of the cone biopsy and therefore they were analysed separately. When accounting for tumour size and histopathology, deep invasion of the stroma was associated with 12-fold higher odds of positive nodes, but affected or uncertain margins was not.
Conclusion*In patients after cone biopsy, the association of tumors > 2cm plus deep stromal invasion (>2/3) is correlated with the higher risk of positive lymph node in early cervical cancer.
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