The rationality of negative margin criteria for conization in early cervical cancer - a cohort study
Abstract
The 2023 (1st Edition) NCCN guideline changed the negative margin criteria for cervical conization from ≥ 3 mm to ≥ 1 mm. To explore the clinical safety of this up-dation in the real world, we performed a retrospective study to validate the rationality of the negative margin criteria for conization in patients with early-stage cervical cancer. We retrospectively collected the clinical and pathological data of 986 patients with early-stage cervical cancer from June 2011 to June 2023. All of the patients underwent conization and secondary (radical) hysterectomy at Tianjin Central Hospital of Gynecology Obstetrics. Patients were divided into four groups based on the status of the conization margins: margin < 1 mm (n = 132), margin < 3 mm (n = 147), margin involved (n = 443), and margin not involved (n = 264). The safety of the negative margin criteria for conization (< 1 mm) was evaluated by comparing the residual disease rates in different groups after secondary (radical) hysterectomy. Additionally, univariate and logistic multivariate analyses were conducted to identify the risk factors for residual disease after hysterectomy. A total of 986 patients with cervical cancer at stages IA1-IB1 were included. Among these patients, 382 had residual diseases (HSIL or higher) after hysterectomy, resulting in a residual disease rate of approximately 38.7%. Patients were categorized based on margin status (< 1 mm, <3 mm, margin involved, and, margin not involved). There were…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 986 participants or records.
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