Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Tsuruma-cho 65, Showa-ku, Nagoya, 466-8550, Japan.
Institute for Advanced Research, Nagoya University, Nagoya, Japan.
Sci Rep. 2021 Dec 2;11(1):23288. doi: 10.1038/s41598-021-02635-y.
Radical surgery after cervical conization is a common approach for the treatment of cervical cancer. In some cases, disease progression is observed after positive margins at conization, but the effect of conization on disease progression remains unclear. Thus, the aim of this study was to investigate the clinical outcomes of positive margins at conization in cervical cancer. A total of 101 patients who underwent cervical conization before radical hysterectomy and pelvic lymph node dissection were considered eligible by reviewing medical records. The association between the positive margins and patient outcomes, including subsequent lymph node metastasis, was evaluated. The rate of lymphovascular space invasion (LVSI) positivity at radical surgery was significantly higher in patients with positive margins (p = 0.017) than in those with negative margins, although there was no significant difference in the rate of pelvic lymph node metastasis (p = 0.155). Moreover, there was no significant difference in the overall survival or progression-free survival between the two groups (p = 0.332 and 0.200, respectively). A positive margin at conization presented no significant prognostic disadvantage; thus, diagnostic conization is one of the most suitable treatment options for early-stage cervical cancer that is difficult to accurately assess.
宫颈锥切术后行根治性手术是治疗宫颈癌的常用方法。在某些情况下，锥切术后切缘阳性会观察到疾病进展，但锥切术对疾病进展的影响仍不清楚。因此，本研究旨在探讨宫颈癌锥切术后切缘阳性的临床结果。通过回顾病历，共纳入 101 例在根治性子宫切除术和盆腔淋巴结清扫术前行宫颈锥切术的患者。评估了切缘阳性与包括淋巴结转移在内的患者结局之间的相关性。在接受根治性手术的患者中，阳性切缘患者的脉管侵犯（LVSI）阳性率显著高于阴性切缘患者（p=0.017），尽管盆腔淋巴结转移率无显著差异（p=0.155）。此外，两组患者的总生存或无进展生存无显著差异（p=0.332 和 0.200）。宫颈锥切术后切缘阳性并不预示预后不良；因此，对于难以准确评估的早期宫颈癌，诊断性锥切术是最适合的治疗选择之一。
