文章：

锥切术对早期宫颈癌根治性子宫切除术后总生存期和无进展生存期的影响：一项倾向性评分匹配分析

Effect of Conization Prior to Radical Hysterectomy on Overall and Progression-Free Survival in Early-Stage Cervical Cancer: A Propensity Score-Matched Analysis

原文发布日期：18 October 2025

DOI: 10.3390/cancers17203360

类型: Article

开放获取: 是

英文摘要：

Objective: To evaluate the association of preoperative conization prior to radical hysterectomy (RH) with overall survival (OS) and progression-free survival (PFS) in patients with early-stage cervical cancer.Methods: We conducted a retrospective cohort study involving patients with stage IB1 cervical cancer treated by RH at Maharaj Nakorn Chiang Mai Hospital, Faculty of Medicine, Chiang Mai University, Thailand, between January 2003 and December 2019. Propensity-score matching (1:1 ratio, caliper of 0.2 standard deviations) was used to balance covariates between patients who underwent conization (n= 314) and those who did not (n= 528). Survival outcomes were analyzed using Kaplan–Meier curves and the log-rank test. Subgroup analysis was also conducted on patients without high-risk histopathological factors, including pelvic node metastasis, parametrial invasion, and positive vaginal margins.Results: A total of 274 matched pairs were analyzed. Conization was significantly associated with improved OS (log-rankp= 0.03). For PFS, the benefit associated with conization was not demonstrated (log-rankp= 0.18). Similarly, subgroup analysis excluding patients with high-risk histopathological factors showed a significant association between conization and improved OS (log-rankp= 0.04) but not with PFS (log-rankp= 0.29).Conclusions: Conization prior to RH is significantly associated with improved OS in patients with early-stage cervical cancer, though its association with PFS remains inconclusive. These findings support the integration of conization into personalized surgical treatment strategies, with further prospective validation recommended.

摘要翻译： 

目的：评估早期宫颈癌患者根治性子宫切除术（RH）前行锥切术与总生存期（OS）及无进展生存期（PFS）的关联性。 方法：本研究为回顾性队列研究，纳入2003年1月至2019年12月期间在泰国清迈大学医学院Maharaj Nakorn清迈医院接受RH治疗的IB1期宫颈癌患者。采用倾向性评分匹配（1:1比例，卡钳值0.2个标准差）平衡接受锥切术患者（n=314）与未接受锥切术患者（n=528）的协变量。使用Kaplan-Meier曲线和对数秩检验分析生存结局，并对无高危组织病理学因素（包括盆腔淋巴结转移、宫旁浸润及阴道切缘阳性）的患者进行亚组分析。 结果：共分析274对匹配病例。锥切术与OS改善显著相关（对数秩检验p=0.03），但与PFS的关联未达统计学意义（对数秩检验p=0.18）。在排除高危组织病理学因素患者的亚组分析中，锥切术同样与OS改善显著相关（对数秩检验p=0.04），而与PFS无显著关联（对数秩检验p=0.29）。 结论：RH前锥切术与早期宫颈癌患者OS改善显著相关，但其与PFS的关联尚未明确。这些发现支持将锥切术纳入个体化手术治疗策略，建议通过前瞻性研究进一步验证。

原文链接：

Effect of Conization Prior to Radical Hysterectomy on Overall and Progression-Free Survival in Early-Stage Cervical Cancer: A Propensity Score-Matched Analysis