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PO001/#381  Is minimally invasive surgery safe for cervical cancer patients with a diameter of less than 2 cm? (MISAFE): gynecologic oncology research investigators collboration study (GORILLA-1003)
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  1. Tae-Wook Kong1,
  2. Jeeyeon Kim1,
  3. Joo-Hyuk Son1,
  4. A Jin Lee2,
  5. Eun Jung Yang2,
  6. Seung-Hyuk Shim2,
  7. Nam Kyeong Kim3,
  8. Yeorae Kim3,
  9. Dong Hoon Suh4,
  10. Dong Won Hwang5,
  11. Soo Jin Park5,
  12. Hee Seung Kim5,
  13. Yoo Young Lee6,
  14. Ji Geun Yoo7,
  15. Sung Jong Lee8 and
  16. Suk-Joon Chang1
  1. 1Ajou University Medical Center, Obstetrics and Gynecology, Suwon, Korea, Republic of
  2. 2Konkuk University Hospital, Obstetrics and Gynecology, Seoul, Korea, Republic of
  3. 3Seoul National University Bundang Hospital, Department of Obstetrics and Gynecology, Seongnam, Korea, Republic of
  4. 4Seoul National University Bundang Hospital, Department of Obstetrics and Gynecology, Seongnam-Si, Korea, Republic of
  5. 5Seoul National University Hospital, Obstetrics and Gynecology, Seoul, Korea, Republic of
  6. 6Samsung Medical Center, Obstetrics and Gynecology, Seoul, Korea, Republic of
  7. 7Daejeon St. Mary’s hospital, Obstetrics and Gynecology, Daejeon, Korea, Republic of
  8. 8Seoul St. Mary’s Hospital, Obstetrics and Gynecology, Seoul, Korea, Republic of

Abstract

Introduction To identify clinicopathologic factors associated with disease recurrence for patients with 2018 FIGO stage IA with lymphovascular invasion (LVSI) to IB1 cervical cancer treated with minimally invasive surgery (MIS).

Methods A total of 722 early-stage cervical cancer patients between January 2010 and February 2021 were identified. All possible clinicopathologic factors related to disease recurrence were analyzed. Disease-free survival (DFS) and overall survival (OS) rates were estimated using the Kaplan-Meier method. To determine prognostic factors for DFS, a Cox proportional hazard regression model was used.

Results Of 722 patients, 49 (6.8%) showed disease recurrence (37 pelvis, 1 para-aortic lymph node, and 11 peritoneum). Five-year DFS and OS rates were 90.7% and 98.1%, respectively. In multivariate analysis, risk factors associated with disease recurrence were residual disease in the remaining cervix (OR, 4.693; 95% CI, 3.719 – 5.667; p = 0.002), intracorporeal colpotomy (OR, 2.960; 95% CI, 1.703 – 3.161; p = 0.017), and positive resection margin (OR, 3.415; 95% CI, 2.351 – 4.479; p = 0.024). The non-conization group had a higher percentage of stage IB1 (77.4% vs. 64.6%; p = 0.004) and larger tumor (16 mm vs. 10 mm; p < 0.001) than the conization group. Intracorporeal colpotomy and residual disease in the remaining cervix were independent variables associated with disease recurrence in patients undergoing MIS following conization.

Conclusion/Implications During MIS, early-stage cervical cancer patients with tumors less than 2 cm can be vulnerable to peritoneal recurrences. Preoperative conization itself may not lower the disease recurrence in early-stage cervical cancer patients undergoing MIS.

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