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2022-RA-927-ESGO Tumor size and oncological outcomes in patients with early cervical cancer treated by fertility preservation surgery: a multi-center retrospective cohort study
  1. Guillermo Fernández Lizana1,
  2. Álvaro Tejerizo García1,
  3. Antonio Gil Moreno2,
  4. Aureli Torné Bladé3,
  5. Ángel Martín Jiménez4,
  6. Berta Díaz-Feijoo3,
  7. Mikel Gorostidi5,
  8. Ignacio Zapardiel6 and
  9. Blanca Gil Ibañez1
  1. 1Hospital Universitario 12 de Octubre, Madrid, Spain
  2. 2Hospital Universitario Vall d’Hebron, Barcelona, Spain
  3. 3Hospital Clinic Barcelona, Barcelona, Spain
  4. 4Hospital Universitario Son Llàtzer, Mallorca, Spain
  5. 5Hospital Universitario de Donostia, San Sebastián, Spain
  6. 6Hospital Universitario La Paz, Madrid, Spain


Introduction/Background The aim of this study was to analyze the impact of tumor size >2 cm on oncological outcomes of fertility-sparing surgery (FSS) in early cervical cancer in a Spanish cohort.

Methodology A multicenter, retrospective cohort study of early cervical cancer (stage IA1 with lymphovascular space invasion -IB1 (FIGO 2009) patients with gestational desire who underwent FSS at 12 tertiary departments of gynecology oncology between 01/2005 and 01/2019 throughout Spain.

Results A total of 111 patients were included, 82 (73.9%) with tumors < 2 cm and 29 (26.1%) with tumors 2–4 cm. Patients’ characteristics were balanced except lymphovascular space invasion. All were intraoperative lymphnode negative. Median follow-up was 55.7 and 30.7 months respectively. Eleven recurrences were diagnosed (9.9%), 5 (6.0%) and 6 (21.4%) (p<0.05). 3 years-Progression free survival (PFS) was 95.7% (95%CI 87.3–98.6) and 76.9% (95% CI 55.2–89.0) (p=0.011). Only tumor size (<2 cm vs. 2–4 cms) was found to be significant for recurrence. After adjusting for the rest of the variables, tumor size 2–4 cm showed a Hazard Ratio of 5.99 (CI 95% 1.01–35.41, p=0.036).

Conclusion Tumor size ≥2 cm is the most important negative prognostic factor in this multicenter cohort of patients with early cervical cancer and gestational desire who underwent FSS in Spain.

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