Introduction Patients with stage IB1- IB2 cervical cancer (CC) had higher risk of recurrence and death after radical hysterectomy, mainly when minimally invasive surgery was performed. The aim of our study was to evaluate the influence of preoperative conization on survival outcomes in patients with CC stage IB1-IB2 treated with radical hysterectomy (RH).

Methods This is a retrospective cohort study of CC patients at Barretos Cancer Hospital from 2009 to 2023. Patients were divided into groups based on previous conization, 2018 FIGO stage and surgical approach. The Kaplan-Meier method was used to compare the survival outcomes between the conization and non-conization groups. A Cox proportional hazards regression model was performed to evaluate prognostic factors for disease-free survival (DFS).

Results A total of 97 patients met the inclusion criteria, 73 (75.3%) patients received preoperative conization and 24 (24.7%) did not. 9 (9.3%) patients experienced disease recurrence, 4 in the conization group, and 5 in the non-conization group. There was no significant increase in the 5-year DFS and overall survival for patients who had previous conization (p=0.056 and p=0.09, respectively). In the univariated analysis, preoperative conization, FIGO stage and stromal invasion were associated with DFS (p<0.2). FIGO stage was the only independent variable associated with disease recurrence.

Conclusion/Implications Preoperative conization, as an independent variable, had no effect on survival outcomes and could not be associated with disease recurrence in patients with stage IB1-IB2 CC.